Chapter 2: The historical origins of modern international health
¾ Civilizations as early as the ancient Chinese, Egyptian, Greco-Roman and Mesoamerican had
expanded beyond local regions.
¾ In Europe the two major pandemics were the Plague of Justinian in 542 CE that spanned from
Asia to Ireland and then the Black Death in the 14th century
o With the Black Death early attempts at international disease control involved
quarantines cities, in particular preventing access by ships, and cordon sanitaire, which
P]}vY Venice established the first lazaretto in 1403, a quarantine station to hold and
international health authority.
o Girolomo Fracastoro, a Veronese physician-scholar, postulated that the plague could
be transmitted via direct contact or the atmosphere which was used as justification for
o By the 18th century new environmental engineering methods were being implemented
and the burial of PP_~îí
¾ The rise of European imperialism
o European imperialism began in the 15th century with the Portuguese attack on Muslim
settlements I 1415
o Imperialism was somewhat an expansion of the Crusades as it can be seen with
Europeans incorporating desire to proliferate Christianity as one of their motives with
the ever present Islamic influence.
o In 17th century Iberian dominance was challenged when the English and Dutch pursued
interests establishing colonies worldwide under European political control
o Health consequences of imperialism can be seen in the high death toll of indigenous
people invaded as the Bishop Bartolomew de las Casas noted in Antilles upon and after
o Medical practitioners had originally been brought to treat military men, but with the
establishment of colonies began to treat the colonists as well as establish rules for
o With growing interest in indigenous knowledge of medicines, Martin de la Cruz was the
first to catalogue indigenous healing knowledge in his Codex Badianus of 1552 produced
for the Spanish emperor.
Colonial Spanish and Portuguese administrations founded medical faculties and
urban elites, Catholic hospitals providing charity care and traditional healers and
Though observed many years ago by Chinese and Ayurvedic healers, Edward
Jenner is accredited for finding the vaccination for smallpox. t Bourbon king of
Spain Charles IV in 1803 sponsored the Balmis-Salvany group to on an
expedition throughout their colonies to vaccinate people for smallpox (the first
mass health campaign)
o Death among the Mestizos and particulary indigenous and African descended
populations can be attributed to slave trade, work in mines, dispossession from land and
livelihood, crowded living conditions, ecological alterations making way for mosquito
breeding thus malaria, etc t though indigenous people suffered from diseases colonists
did as well: ex t in the Niger Expedition of 1841, permitted as an alternative to slave
trade to satisfy abolitionists all but 3 of the 35 Europeans died from malaria
¾ Slave trade
o Africans were used a slaves because (1) skin color was easier to spot if they escaped, (2)
they were believed to be physically adapted to work in tropical climates, (3) and they
were easy to capture due to separated social groups and limited weaponry in Africa.
o An estimated 11.4 Africans were captured between 1502 and 1870 and about 12-15% of
¾ Health, the tropics and the imperial system
cultural alienation and environment distinction between Europe and these locations.
explanations regarding susceptibility to disease, sustainability for work and
to address the interaction of political and economical factors with ecological
o The demand for good from colonies increased the need for slave trade and later large-
scale hiring of contract workers which had health implications.
when the rubber industry became lucrative and grew them in the Malay
Peninsula. But with a paucity of local population and abolishment of slave trade
thousands of Tamils were transferred resulting in severe malaria, hookworm,
etc in rubber estates.
o ^/u]o]uZvÁas shaped by patterns of malaria infection. Rapid
Development, the building of cities and clearing of roads, and inadequate drainage and
It was Jesuits in S. America in the early 1600s that learned about local cure for
malaria using the Cinchona bark. It became highly demanded resulting in
depletion of the trees until the Dutch established plantations in Java which was
development of synthetic anti-uo]oUµZZo}}µ]v_~îô
Important people in the discussion of malaria: Charles Laveran discovered the
malaria parasite in 1880. Patrick Manson, British physician-parasitologist,