Featured Research

Epidemic Invasions

Yellow Fever and the Limits of Cuban Independence

On April 25, 1898, the United States declared war on Spain and promptly invaded the Spanish colony of Cuba. Why? Drawing on our junior high school history classes, many of us would respond, “To ‘Remember the Maine,’” the U.S. warship that exploded and sank in Havana’s harbor a few months earlier. But, as Mariola Espinosa, a newly-recruited assistant professor in the Section of the History of Medicine, points out, the U.S. government had already decided on war the preceding fall, before the Maine was ever sent to Cuba. At that time, U.S. minister to Spain Stewart Woodford was charged with laying out the grounds for war to Europe’s other powers. First and foremost, Woodford explained, was yellow fever.

The Story

Espinosa tells the story of how the devastating power of yellow fever dramatically transformed and defined the relationship between Cuba and the United States in her new book, Epidemic Invasions: Yellow Fever and the Limits of Cuban Independence. Yellow fever was endemic to nineteenth century Havana, and commercial traffic with that port regularly brought the fearsome disease to the U.S. South. When an epidemic again spread across the panic-stricken southern states in 1897, it underscored the fact that Spain was unwilling or unable to control the source of infection in Cuba, and the U.S. government at last decided to take the matter into its own hands.

U.S. military doctors eventually succeeded in eliminating yellow fever from the island, but Espinosa reveals that this was no act of beneficence: most Cubans were immune to the disease from childhood infection and suffered little from it. And concerns in the United States about yellow fever continued to powerfully shape the limits of Cuban independence: the United States demanded that Cuba pledge in its constitution to maintain the public health measures established during the occupation before withdrawing its troops. Only after the U.S. Army again occupied the island from 1906 to 1909 did Cuban government officials and sanitarians come to realize that keeping the island free of yellow fever was critical to its independence, but they refused to accept that the U.S. domination that made these efforts so paramount was legitimate.

By illuminating this history, Espinosa brings to the Americas for the first time the insights garnered by historians of colonial public health in other parts of the world. Scholars of European colonial public health have long recognized that disease-control policies primarily served the interests of the colonizers rather than the colonized: public health was at once a means of protecting imperial interests in trade and an instrument by which social control was exerted and justified. She reveals that these insights hold no less true for the often informal imperialism of the United States than for the overt colonialism of the European powers. The U.S. programs of sanitation and disease eradication in the Latin America and beyond that began with the efforts in Cuba were not charitable endeavors, but served to eliminate threats to the United States and the continued expansion of its influence in the world.

 Ongoing Research

This fall, her first at Yale, Espinosa has been sharing her expertise on the relationships between disease, medicine, and empire in the Caribbean with students in a graduate seminar; in the spring, she will teach an undergraduate course on the history of medicine in Latin America and another on historical methods. She is now in the beginning stages of a project that will examine how disease affected the maintenance of empire and competition between imperial powers across the Caribbean, with the twin goals of comparing the Cuban experience with those of people elsewhere in the Caribbean and finding the interconnections that the participants and contemporary observers made among these critical episodes in the history of the region.

“The Caribbean,” Espinosa recently explained, outlining her ongoing research program, “provides me with numerous angles of inquiry into the role of disease in relations between peoples in an age of empires. There you have a diverse and often hostile environment, where peoples from all parts of the globe converge in a limited space, and competed with each other. So I can look at, for example, the role of yellow fever in Spanish loss of empire in Cuba in 1898, and evaluate that alongside the British incursions within the French colonies during the French Revolution. The Spanish Caribbean has traditionally been studied in isolation; my goal is to show how these colonies, while having different metropoles, were not as isolated as we study them.”

“The Caribbean is a particularly challenging disease environment for imperial powers. It became a crossroads between Europe, Africa, North and South America. And each region contributed its diseases to this environment making it completely inhospitable to outsiders. At the same time it was very desirable and became the object of struggle between and among all the major imperial powers. I want to know, how did each of them cope with the extraordinarily lethal combination of diseases found there, and how it affected the relationship between the colonized with their colonizers? Did the locals use this to their advantage? Not only will I do this by comparing historical episodes, but I will also trace the ways in which conceptions of disease and reactions to them in the region change over time and how previous experiences influence later ones.”

Professor Espinosa’s plans at Yale include convening an international conference in New Haven that will bring together scholars exploring medicine, colonialism, and imperialism in Asia and Africa with scholars whose research focuses on the history of medicine and public health in Latin America.