Plague and Fire
Page 10
Hawaiians joined the chorus of recrimination. Ke Aloha Aina, for example, published the observations of a man who had gained access to the quarantined zone by working as a servant in the district's cleanup operations. "The Japanese and Chinese are not the unclean ones who are spreading the plague in the city," he concluded. "Instead, it is the large land owners who rent units on a large-scale profit. These are people such as Samuel Damon, Dillingham, Keoni Kolopana and some others who sit and collect huge monthly and annual profits. The Chinese and Japanese," in the view of this Hawaiian observer, were merely "tenants trying to make a living for themselves and their children. The units [regarded as foul by the Board of Health] are convenient for the time being until they can secure more permanent residences." The Hawaiian press editorialized that large landlords should be forced to bring such units up to acceptable standards at their own expense or be compelled to pay for their destruction."
After five days of anxious quarantine, medical debate, and no additional deaths, the beleaguered physicians on the Board of Health loosened their regulations. They permitted public trams to pass through Chinatown, provided they did not stop in the quarantined zone, thereby reconnecting the areas west of Nuuanu stream to the center of the city. Mail delivery resumed in Chinatown. "The danger seems to be over," speculated the city's newspapers, "and the quarantine will undoubtedly be raised within a short time." Through the Chamber of Commerce, the city's retail merchants pressed the Board to relax the quarantine as quickly as possible to leave time for last-minute Christmas shopping."
Following a closed meeting on December i 8, Emerson, Day, and Wood voted to terminate their week-long quarantine. Some Japanese businessmen called the Board's quick decision "careless," since they now contendedin contrast to their initial protests-that if plague bacteria had really been in the city, then they were almost certainly still lurking in the area. More pointedly, they observed that they would suffer long delays in retrieving their goods from quarantined warehouses, while their white competitors would be in a position to cash in on pent-up holiday demand just as soon as normal business resumed. Consequently, Japanese merchants again saw "racial bias" behind the Board's hasty decision to lift its emergency regulations, and they assumed that white businessmen must have bribed the Board's physicians to reopen the city on terms that favored them.13
The final hours of the quarantine did not pass smoothly. After rumors circulated about the mysterious death of a Chinese woman inside the quarantined district, medical inspectors broke down the door to the house where the woman's body lay and performed a postmortem examination. With palpable relief, they concluded that she had died as the result of a fall. More ominous was the case of a white teenager named Ethel Johnson, who lived on the Iwilei Road between Chinatown and the harbor. The Board physicians who examined the teenager considered her case "highly suspicious" and ordered a miniature quarantine and an armed guard placed around the Johnson house, but they did not immediately declare her a plague victim. Ke Aloha Aina reported that Hoffman believed Ethel did have plague, but another doctor had objected to the diagnosis "since she was a white girl, and [the other doctor] wished to save her from being grouped together with Hawaiians, Japanese and Chinese, an act which would defile the dignity of their whiteness, the people who control and rule this archipelago .1114
If Ethel did have bubonic plague, the Board's physicians hypothesized, she probably contracted it from the human waste being hauled from the privies of Chinatown past her house to a seaside dump. As a precaution, the cleanup crews were ordered to change their routes to avoid residential areas. In any event, the girl had survived her first wave of fever, and even if she should take a turn for the worse, she lived outside the quarantined area. So the Board officially lifted the quarantine of Chinatown at noon on December 20 and permitted public activities to resume throughout the city. Newspapers likened the scene to the Oklahoma land rush as Chinatown's residents flowed back across the painted lines into the central city. Public transportation resumed its normal functions, schools reopened, and scores of ships, which had been moored for a week, cheerfully departed for Pacific destinations from Sydney to San Francisco.''
The citizens of Honolulu quickly resumed their normal patterns of life as newspaper headlines confidently declared, "PLAGUE STAMPED OUT." A housewife remembered that "the quarantine was raised on Chinatown and all was bustle as the merchants made up for lost time." Freighters offloaded their cargo, schools reopened, and city merchants hoped for a lastminute Christmas rush. But Emerson, Day, and Wood, still smarting under the charges of doing too little before the plague arrived in Honolulu and too much after it showed up, remained proactive. They hoped that their prompt and decisive intervention had checked an initial onslaught of plague at home, but they remained concerned that the larger world pandemic showed no signs of abating. Plague continued to rage throughout Asia and regularly appeared in new sites from Australia to Portugal. So the three physicians realized that their city remained as vulnerable as ever. Consequently, only three hours after the quarantine officially ended, they met again with President Dole to outline additional actions designed to avoid future crises.16
Chief among their propositions was a massive sanitary initiative in Chinatown. Though no one made public reference to the accusations of previous dereliction leveled against the government's public health team, everyone on the Board of Health now resolved to be much more vigorous in their hygienic oversight of that district. Their plan called for an ad hoc sanitary committee to conduct a survey of what needed to be done, and they proposed a special appropriation of $ i oo,ooo to pay for it. New excavating equipment would have to be purchased, a new city incinerator would have to be constructed, two new water filtration systems would have to be installed, and new sewers and drains would have to be laid. Individual owners would be assessed the cost of bringing their private property up to sanitary standards previously set by the Board. C. B. Reynolds, who had conducted medical surveys while chief executive officer to the kingdom's Board of Health in the late i88os and early i8gos, agreed to head the ad hoc sanitary committee for Chinatown, and he was joined by two government loyalists, Judge George R. Carter and F. B. Edwards."
Chinatown residents awaiting the official end of the December quarantine. Hawaii State Archives
According to the press, most people in the city agreed in a general sense with the Board of Health's basic premise: improving the sanitary condition of Chinatown should be a civic priority. How could they disagree? But serious questions surfaced immediately. No one knew for certain whether the Board of Health could still draw at will upon the treasury after the plague emergency ended, or how the continued depletion of the republic's treasury might impact the territorial debates in Washington. Both wealthy landlords and marginal business owners inside Chinatown were leery of a sudden and rather arbitrary policy that was being promulgated by a nonelective board and might cost them large sums of money to improve property they already considered hygienically adequate. Political opponents of the Dole government feared the proposal as a raid upon the treasury and a way of steering lucrative government contracts toward friends of the Dole administration. Chinese consul Yang, who had supported the Board during the quarantine, now announced his formal opposition to the peremptory sanitation plan."
Even as the press debated how to pay for the cleaning of Chinatown, Emerson, Day, and Wood began to receive alarming reports of more deaths. On December 2 3, they learned that Ethel Johnson had succumbed at her home. The next day a twenty-seven-year-old Chinese laborer known as Ah Fong, who had lived in Chinatown during the quarantine, was found dead in the adjoining Palama district. Autopsies confirmed what Emerson, Day, and Wood feared most: both victims had certainly died of plague. They also learned that some traditional Chinese healers had apparently resumed the practice of covering up plague deaths to avoid mandatory cremation, which raised the possibility of even more new cases than the ones they knew about. Though sorely tempted to take punitive action against
the Chinese practitioners implicated in the mortuary cover-ups, the doctors decided not to provoke open confrontation and backed off. Besides, the next day was Christmas; perhaps things would improve."
Emerson and his wife Sarah were sitting at their dining room table the following afternoon when a knock at the front door interrupted their Christmas dinner. The same thing happened at Day's house and at Wood's. A twenty-four-year-old Chinese laborer named Chong Mon Dow had been found dead in Chinatown, and the people who found him had sent messengers to the homes of the Board's three physicians. All three doctors rushed off to inspect the body. Another impromptu autopsy confirmed what they already knew: his lymph system was bursting with pestis.
The three physicians returned to their downtown office and reluctantly faced the fact that the epidemic had indeed returned. Christmas or not, they now felt they had no choice but to declare Honolulu again under attack from bubonic plague-which they solemnly did that afternoon in a formal vote. To do otherwise, they resolved, would be cowardly and dangerous, since none of them-and none of the physicians working with them-could any longer seriously doubt "that these cases with hemorrhagic buboes are cases of plague." Even some of the physicians who had publicly questioned the Board's diagnoses during the first wave of cases now reluctantly conceded that Hoffman's earlier bacteriological conclusions must have been accurate.20
The Dole administration immediately summoned all foreign consuls in the city to the capitol building and officially informed them that Honolulu was once again an "infected port" under international protocols. Carmichael dispatched similar notification by ship to his counterparts at the Marine Hospital Service in San Francisco; they would have to guard that port of entry to the United States and decide whether or not to continue to send American troops to the Philippines by way of Hawaii. As spokesman for the interim government of an American possession, Dole's consulgeneral also felt obliged to send formal notification to the U.S. State Department in Washington. Everyone realized that this was "a very serious matter and a very sad Christmas present for Hawaii.""
By official decree, the "existing government" reaffirmed the absolute emergency powers of the medical triumvirate throughout the Hawaiian archipelago, effective December 26, 1899. Sheriffs on the outer islands were formally declared agents of the Honolulu Board of Health. The decree reasserted the physicians' power to quarantine individual properties on an ad hoc basis and larger districts as they saw fit. Fearing that a general quarantine of Chinatown might be reinstated at any moment, Japanese and Chinese were reported to be "excitedly running with sachels [sic] to the homes of family members outside the [Chinatown district]." They were worried "that their homes will [again] come under quarantine and that they will lose their jobs."22
For the next several days, Emerson, Day, and Wood wrestled with the problems already at hand, considered various steps they might take, met with many groups to hear different points of view, and tried to grope their way toward a coherent set of public policies. The first problem they addressed was the alleged concealment of plague victims among the Chinese. They sent word to "the merchants and leading men of the Chinese colony" that they needed "assistance in suppressing the plague" and arranged for a meeting on the afternoon of December 26. With Wood's friend W. H. Crawford acting as interpreter, the Board's physicians assured the Chinese representatives that they were not being singled outcremations were being performed solely on the basis of public safety. They reminded the Chinese that "only last Saturday [when] a white girl [Ethel Johnson] died of the plague, we cremated her just the same as we did in the cases of your countrymen." They also squelched a rumor circulating in the sharply factionalized Chinese community that Consul Yang was complicit in the decision to cremate earlier Chinese victims because they had not been among his political supporters.23
By the end of the meeting, a rough agreement had emerged. Chinese physicians could continue to treat all sicknesses in their community, with the exception of plague. Plague patients would be removed to a special plague hospital set up by the Board of Health. The bodies of plague victims would be given to the Board of Health for disposal, but Consul Yang would be formally notified prior to cremation, in order to verify the identity of the deceased. To partly offset the horror of cremation, Emerson, Day, and Wood promised to return the bones and ashes of plague victims to the families or friends of the deceased. In another shrewd concession, the physicians won key support from the Chinese business community by agreeing to fumigate any of their suspect merchandise at public expense if the businessmen, in turn, provided the warehouse space for that process to take place. Chinese merchants had lost thousands of dollars during the mid-December quarantine and had come to the meeting fearful of more costly embargoes in the future.24
Hoping that the special meeting had assuaged the city's principal Chinese leaders, the three physicians turned to other issues. As the first step in their proposed sanitizing of the Chinatown district, they ordered an immediate reinspection to determine the feasibility of a new sewage system. Since several of the physicians working with Emerson, Day, and Wood shared their long-standing suspicion that rats were somehow involved in the spread of plague-even though none of them knew exactly how-the triumvirate announced a bounty of ten cents apiece on dead rats.
The Board also issued a circular printed in English, Hawaiian, Portuguese, Japanese, and Chinese, outlining "Precautions Against Bubonic Plague." The circular began by asserting the common wisdom that "Plague germs flourish in filth, in garbage and in damp, dark or foul places." Consequently, cleanliness was essential. Cuts and scratches should be covered; food should be well cooked. The circular also invoked Kitasato's soil theories: "Dr. Kitasato, the celebrated plague specialist," stated the circular, believes that plague frequently attacks people from the ground up. "Therefore," warned the Board's physicians, "it is dangerous to go barefoot in times like this; wear shoes." Finally, admonished the circular, "destroy all the rats and vermin on your premises and the danger of plague will become less." 25
Barely a day and a half into the post-Christmas emergency, the situation inside Chinatown seemed to be deteriorating rapidly, particularly among the Chinese. After angry protestors threatened Li Khai Fai for his continuing cooperation with the Board of Health, the triumvirate felt the need to post permanent police protection outside Li's Chinatown home. Handbills urging independent resistance against white medical policies and against Consul Yang's cremation concessions were tacked up around Chinatown. Nervous white businessmen urged Emerson, Day, and Wood to crack down on "the agitators who are inciting the Chinese." They favored the use of live ammunition if necessary.26
Some Chinese continued to conceal suspected cases of plague not only from white medical inspectors but also from neighbors who complied with the consul's agreement. Other Chinese had begun to expel ailing countrymen from their midst, fearing that plague cases might provoke ad hoc quarantines around the houses and stores where they lived and worked. As a result, the dead bodies of Chinese workers were discovered around the city in apparently random public places. In one sad case, a body was found lying outside the locked gates of the Chinese hospital.27
Vice-Consul Gu still remembered that last incident many years later. A Chinese doctor had decided he could do no more for a patient named Chen, so he advised the man's friends to tell him to go to the Wai Wah Yee Yuen hospital in the Palama district and hope for the best. Though the doctor dared not tell Chen's friends, he feared that Chen might infect the entire hospital if he lived long enough to be admitted. So the doctor first sent secret word to hospital director Tong strongly advising against the admission of Chen, then notified Board headquarters that he had heard rumors about a possible plague case in the neighborhood of the hospital. To verify the rumor, Board physicians went to Wai Wah Yee Yuen, where they found Chen's lifeless body huddled against the hospital fence. His remains were removed for immediate cremation. Emerson, Day, and Wood regarded incidents like that-however understandable given the constraints
facing their Chinese colleagues-as dangerously irresponsible, since they involved the dispersal of patients full of pestis.28
To make matter worse, discouraged health inspectors found several sites inside Chinatown that seemed more unsanitary than they had initially appeared during the emergency survey just a week earlier. Indeed, preliminary reports from the ad hoc sanitary committee suggested that the Board's grand plans for vigorous sanitary improvements and sewer construction in the Chinatown district would likely be more difficult to implement and more costly to finance than initially imagined. The cleanup could probably not be accomplished quickly, or at least not quickly enough to quash the burgeoning crisis at hand.
Among the few bright spots from the Board's point of view was the active cooperation of Honolulu's most influential Japanese physicians. Under the Westernizing mandates of the Meiji government back home, these doctors had been trained to approach medical issues in much the same way their American counterparts approached them. They revered Kitasato as a national hero. Mitamura Toshiyuki, who had been practicing in the Hawaiian Islands since 1888 and had strong ties to many American physicians through their mutual commitment to the Christian social movement, coordinated the flow of medical information from the Japanese community to the Board of Health. He and five Japanese colleagues organized a team of thirty-one community inspectors to conduct rigorous patrols throughout the Japanese portions of Chinatown. Far from concealing suspicious cases, much less suspicious deaths, the Japanese physicians systematically referred all patients with the slightest hint of plague symptoms to the Board's plague hospital at Kakaako. Mitamura also visited the hospital every day to help care for the Japanese-speaking patients. When many of those patients proved not to have plague, they were released to their homes and to their regular physicians for further treatment.29