Public health

The meaning of public health has evolved historically to indicate disease control, sanitation, disaster epidemic relief, and mental and physical health protection of the population as a whole. ¹ At the turn of the twentieth century, the concept of public health carried a distinct significance of national power and social progress, as the advancement of nations was measured by national death rates and sanitary control. Administration of public health was the responsibility of local and central governments of modern nations. Ruth Rogaski used “hygienic modernity” to describe this modern phenomenon of national power, which she defined as a combination of state power, scientific progress, cleanliness, and the fitness of races. ² Public health also became a contentious issue in the relations between Western imperialist powers and non-Western countries in regard to modern reforms and sovereignty. In 1901, administration of public health became a significant point in the negotiations between China and foreign powers for the return of Chinese cities after the suppression of the Boxer Uprising (义和团运动). ³ The Qing court had to agree to continue the sanitary work of foreign occupation before the powers would return Beijing and Tianjin to China. The matter of hygienic modernity came up again in 1910 when a pneumonic plague epidemic caused a full-blown public health crisis in northeast China. Foreign powers in the region expanded their control of city districts in the name of health protection, undermining China’s sovereignty in controlling the epidemic and its territory. Known as the Manchurian plague in the West, this deadly epidemic took more than 60,000 human lives and caused financial losses of 100 million dollars. ⁴ The scale of mortality and socio-economic devastation was considered to have “rivaled or exceeded the Great Plague of London” in 1665–1666. ⁵ For the Qing dynasty, the Manchurian plague presented as much a public health crisis as a political challenge to keep China’s sovereignty.