Post Magazine / Books
Review | Forbidden Memory explores the role of Tibetan Red Guards in the Cultural Revolution

The starting point for Tsering Woeser’s book was a trunk of photographs taken by her father in Tibet in the 1960s

Based on more than 70 interviews, Woeser makes a powerful and nuanced argument against popular perceptions
Ajay Singh Published:  30 May, 2020

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The cover image from Forbidden Memory, Tibet During The Cultural Revolution, by Tsering Woeser. Photo: Handout
Forbidden Memory: Tibet During the Cultural Revolution
by Tsering Woeser
Potomac Books
4/5 stars

The Dalai Lama has called it “the most sacred temple” in Tibet. Located in the capital, Lhasa, and dating back to the seventh century, the Jokhang temple is a magnet for devout Tibetans who gather there every day to pray, prostrating themselves on the ground.

But among the worshippers who visit Jokhang these days, it would not be unusual to find former cadres of Mao Zedong’s revolutionary Red Guards – Tibetans who helped ransack the temple in the early years of China’s tumultuous 1966-76 Cultural Revolution.

That is the disquieting belief of Tsering Woeser, a Tibetan intellectual, blogger and critic of Beijing’s Tibet policies. In her latest book, Forbidden Memory: Tibet During the Cultural Revolution, the Beijing resident dives into one of the most traumatic chapters in Chinese history, during which cultural relics were destroyed and political enemies were targeted for public abuse and humiliation.

A rally at the People’s Stadium, in Lhasa, Tibet, on August 19, 1966. Photo: Tsering Dorje

The book is an updated English translation of Shajie, the title under which Woeser first published her work in Chinese, in Taiwan in 2006, the 40th anniversary of the start of the Cultural Revolution\

Based on interviews with more than 70 people who lived through the Cultural Revolution, Forbidden Memory contains hundreds of photographs from the period taken by Woeser’s father, Tsering Dorje, a People’s Liberation Army officer born to a Chinese father and Tibetan mother

Woeser, who was born in 1966 just as the Cultural Revolution was beginning, inherited the photographs after her father died in 1991. But it wasn’t until 1999 that she thought of doing something with what she describes as “the most complete private record of these events yet to have come to light”. That year, she mailed the photographs to Wang Lixiong, a Chinese dissident whose book, Sky Burial: The Fate of Tibet (1998), she had just read.

“I had never met him, but I thought that rather than leave father’s photographs sitting in the trunk, it might not be a bad idea to entrust them to a scholar willing to study Tibet in a balanced way,” Woeser writes.

Wang promptly returned the images. By letter, he explained they “belonged to the yet-to-be-rediscovered memory of Tibet”, as Woeser puts it. He said he would be willing to help –
Woeser and Wang eventually married – but as an outsider he was reluctant to take on the task alone.

The photographs in Woeser’s book depict everything from the destruction of religious relics, “struggle sessions” (a form of public humiliation and torture) and militia training to rallies, parades and manual labour. Just about every image captured by Woeser’s father is a precious historical resource: “until Woeser released this book there were no images of that period from Tibet in public circulation, either in Tibet or elsewhere in the world”, writes Robert Barnett, a British scholar of Tibetan performance art and media, in the book’s introduction.


Many of the photographs attest to the vandalism and violence of the revolution. When Red Guard cadres ransacked the Jokhang in 1966, for example, Woeser’s father photographed a young Tibetan woman hacking off the golden edging of the temple’s roof with a harrow.

The woman, like her compatriots, was following one of the revolution’s central tenets: denounce the “four olds” – old society, old culture, old traditions and old habits. Woeser wonders why the woman appeared to believe that “turning the past to ruins would give birth to a bright new world”. Her question, like many of the book’s 345 images, challenges readers “to try to understand the ideological constructions of the time that made such actions seem natural and even necessary to so many participants, both the rulers and the ruled”, writes Barnett.

In lucid, engaging prose interspersed with her own insights, Woeser highlights how the Cultural Revolution shaped the contours of Tibet’s negotiation with communist China. Her account is a powerful, nuanced argument against the popular perception that Tibetans strongly resisted Beijing’s secularisation and sinicising policies.

Woeser is intrigued by the possibility that many Tibetans became Red Guards, attracted to new ideas and revolutionary fervour. At the same time, she writes, “the atmosphere of red fear created by the authoritarian regime” probably left them no choice but to be “sucked against their will into the string ride of radicalism”.

Lhasa’s Jokhang temple, in 2012. Photo: Tsering Woeser

A close look at a photograph depicting the installation of a Mao portrait on the rooftop of the Jokhang illustrates the author’s viewpoint. The image captures crowds gathered to watch uniformed Red Guards place the portrait and a Chinese flag in a spot previously occupied by the Wheel of Dharma, a revered Buddhist symbol.

“Tibetans would not easily abandon their gods,” Woeser writes. But the occupation and the Dalai Lama’s 1959 exile, “seem to have shown that the new god was so powerful that the ancient gods of the land had been defeated”.

She adds: “Tibetans can be said to have been in shock, stunned by everything that was unfolding before their eyes, so that when the Cultural Revolution took place, they accepted the new reality.”



Ajay Singh is a Los Angeles-based journalist who worked as a staff correspondent for Asiaweek magazine in Hong Kong in the 1990s and in the New Delhi bureaus of The Associated Press and The Wall Street Journal Asia.

Post Magazine / Books

Review | The Road: new book shines a light on Indonesia’s 50-year forgotten war in West Papua as it flares again

Australian journalist John Martinkus documents West Papuan indigenous tribes’ fight to recover ancestral lands annexed by Indonesia

Construction of a controversial highway sparked an escalation last year with Indonesia deploying troops and chemical weapons

Tom Fawthrop 6 Jun, 2020

Central Highlands villagers, shown here with the Morning Star flag in the West Papua capital, have been fighting to recover their ancestral lands for 50 years. Picture: Getty Images

The Road: Uprising in West Papua
by John Martinkus
Black Inc
3.5/5 stars

After 50 years of popular resistance to Indonesian rule in West Papua, this forgotten war is flaring up again. 

The indigenous movement, led by the United Liberation Movement for West Papua (ULMWP), has never lost hope of recovering ancestral lands dating back centuries before their annexation by Indonesia.
Military operations intensified in the Central Highlands region of Nduga last year as the uprising spread. Another 16,000 troops were dispatched to protect the construction of a controversial Trans-Papua Highway. Helicopters dropped bombs and strafed villages. About 45,000 refugees fled across the border into Papua New Guinea.

“It is the helicopters that are the worst. They are used as platforms to shoot or drop white phosphorous grenades or bomblets that inflict horrible injuries on the populace,” John Martinkus writes in his new book, The Road: Uprising in West Papua.


Martinkus depicts a dirty little war far removed from the glittering shopping malls of Jakarta, in a distant out­post of the vast Indonesian archipelago, hidden from the world. The Indonesian military denies it uses white phos­phorus, a banned agent of chemical warfare. But photos of the Papuan victims in the book display gruesome wounds consistent with this chemical.
The Australian journalist has risked his life many times bringing news from the front lines in East Timor and Aceh, and is now committed to lifting the veil of secrecy over West Papua. At least eight foreign journalists – including Australian, Dutch and Swiss – have died reporting from these Indonesian war zones.

Martinkus writes: “After seeing the violence and knowing people the Indonesian security forces have killed, tortured and jailed in East Timor, Aceh and Papua, I cannot, as a human being and a journalist, walk away from this story and let the lies, obfuscations and outright atrocities against the people of those three Indonesian conflicts go unreported.”

The Indonesian government has a different narrative. It says it wants to bring development to a remote province by building an ambitious road – the 4,300km Trans-Papua Highway, costing US$1.4 billion – through the jungle to bring “wealth, development and prosperity” to the isolated regions of West Papua.

But that is not how West Papuans see it, according to Martinkus. “The road would bring the death of their centuries-old way of life. The highway brings military occupation by Indonesian troops, exploitation by foreign companies, environmental destruction and colonisation by Indonesian transmigrants from other provinces.” This mineral-rich region hosts the world’s largest gold mine and second largest copper mine.

The Suharto-era transmigrasi policy involved organi­sing a massive migration of farmers from overpopulated Java to become settlers in West Papua. Many believe the highway will increase the number of settlers and the Melanesian tribes are convinced this will pave the way for their cultural extinction.

Author John Martinkus. Photo: Handout

When East Papua celebrated its independence, in 1975, as Papua New Guinea, the western part of the island was saddled with a shoddy United Nations-brokered deal (1969) awarding de facto sovereignty to Indonesia. Papuans passionately believe they were cheated.

While the book draws many parallels between the East Timor and West Papua conflicts, it does not give enough coverage to the major differences between the two liberation struggles. In the case of West Papua, Indonesia steadfastly claims the 1969 UN agreement granted it eternal sovereignty over West Papua.

Key Western governments – the United States, Britain and France on the UN Security Council, and Australia, Indonesia’s closest neighbour – all have substantial business investment, trade and military ties with Jakarta. They are only too happy to support Jakarta’s narrative that it is fighting a “separatist rebellion” and defending its sovereign territory.

By appointing a controversial general, Wiranto – who goes by one name – as the senior minister dealing with West Papua, Indonesian President Joko Widodo has tied himself to a militarist policy. Wiranto was indicted for crimes against humanity in East Timor by a UN court in 2003, but Jakarta declined to hand him over.
Two decades later, Wiranto has rejected all Papuan demands to end the war by agreeing to a referendum with the words: “The door is closed to any referendum.”

Indonesian President Joko Widodo (second right) with his delegation to look at the Trans-Papua Highway. Photo: AFP
The big difference with East Timor was that the UN never recognised Jakarta’s annexation and, together with former colonial power Portugal, pushed for the referendum that delivered independence.

In 2019, after years of isolation, a diplomatic campaign by the ULMWP took off. The group was granted observer status at the Pacific Islands Forum and its call for a referen­dum was backed at the UN General Assembly by several Melanesian governments.

Last year, the exiled West Papuan leader and ULMWP chairman, Benny Wenda, delivered a historic petition with 1.8 million signatures to Michelle Bachelet, director of the UN Human Rights Council. It was smuggled out from the West Papua jungles on a long, perilous journey to her office in Geneva, Switzerland. Bachelet has expressed grave concern over the situation in West Papua but, predictably, Jakarta has denied her requests to allow a UN human rights mission access to the region.

With no referendum or international effort to restrain the Indonesian army, this book serves as grim reminder that another genocide could be in the making and, like the Rohingya in Myanmar, another outpouring of refugees.

Post Magazine / Books
Review | Sukarno, Suharto, and the US-backed mass murder of communists in Indonesia that set the template for Cold War regime change worldwide

Slaughter in Indonesia in 1965 set template for the systematic mass murder of civilians in the name of anticommunism, Vincent Bevins says in The Jakarta Method
‘This was one of the most important turning points of the 20th century, eliminating the largest communist party outside China and the Soviet Union,’ he writes


Kit Gillet Published:  28 Jun, 2020

Indonesian president Sukarno (left), who handed over his presidential power to military strongman Suharto in February 1967, is shown with Suharto during an Independence Day Parade in Jakarta, in October 1966. Photo: AP

The Jakarta Method by Vincent Bevins, PublicAffairs. 3/5 stars

In 1965, the Indonesian military killed as many as one million of their own country­men, destroying the third-largest communist party in the world and taking with it pretty much anyone seen as having left-wing tendencies (as well as hundreds of thousands who had nothing to do with anything).


Not many people were killed in the streets or officially executed, but rather disappeared into the night.

On the island of Bali, at least 5 per cent of the population, about 80,000 people, were killed, but even today, the events of 1965 are little known outside Indonesia, or even within it.

“For more than 50 years, the Indonesian government has resisted any attempt to go out and record what happened, and no one around the world has much cared to ask, either,” writes journalist Vincent Bevins in The Jakarta Method: Washington’s Anticommunist Crusade and the Mass Murder Program that Shaped Our World. The book attempts to lift the veil while also putting the bloody events in a global context and pointing an accusatory finger at the United States.


In many ways the violence was a result of actions by the American government and the CIA, which during the Cold War used any means possible to stop the spread of communism. This often involved installing friendly right-wing strongmen in countries around the world, even if it meant overturning democratic processes and being complicit in acts of brutality.

Indonesia in 1965 wasn’t the first time the US govern­ment got involved in overthrowing an elected government, or the last, but it would be highly consequential.

“This was one of the most important turning points of the 20th century, eliminating the largest communist party outside China and the Soviet Union and inspiring copycat terror programmes in faraway countries like Brazil and Chile,” writes Bevins.


Between 1945 and 1990, a loose network of US-backed anti-communist extermination programmes carried out mass murder in at least 22 countries, and these groups often learned from one another, adopting methods developed in other countries. Some used the term “Jakarta”, harking back to events in Indonesia.

America has come to terms with Indonesia’s past. Why can’t Indonesians?
29 Oct 2017


Like many countries during this period, Indonesia, a parliamentary democracy and the world’s fourth most-populous country, had tried to remain neutral, engaging and often receiving aid from both the US and the Soviet Union. However, under president Dwight D. Eisenhower, the US began to take a more aggressive approach to deciding if and when an independent nation had become insufficiently anti-communist, writes Bevins. Indonesia and its playboy president, Sukarno, increasingly came under the microscope.

Bevins, a Southeast Asia correspondent for The Washington Post and previously the Brazil correspondent for the Los Angeles Times, has created a powerful record of the often-muddled events in Indonesia following a botched coup on September 30, 1965, which was blamed on commu­nist forces.

The book covers the appearance and rise of military strongman General Suharto, who was considered friendly to US interests and would go on to rule the country until 1998.

“Everything Suharto did in October [1965] suggests that he was executing an anti-communist counter-attack plan that had been developed in advance, not simply reacting to events,” writes Bevins, who adds that Washington quickly began to supply communication equipment to the army and made it clear that direct assistance could resume if the local communist party was destroyed, the president removed, and attacks on US investments stopped

Most disturbing, the US embassy prepared lists of the names of thousands of communists and suspected commu­nists, “and handed them over to the army, so that these peo­ple could be murdered and ‘checked off’ the list”. One embassy worker reportedly said that he “probably has a lot of blood on my hands, but that’s not all bad”. Managers of US-owned plantations also furnished the names of “troublesome” communists and union organisers, who were subsequently killed

Meanwhile, American publications and journalists parroted the official line, even as rumours of widespread violence circulated and a further million citizens were herded into concentration camps.

Perhaps not surprisingly, it worked. “Almost overnight the Indonesian government went from being a fierce voice for Cold War neutrality and anti-imperialism to a quiet, compliant partner of the US world order,” historian John Roosa is quoted as saying.

“I came to the conclusion that the entire world, and especially the countries of Asia, Africa, and Latin America … has been reshaped by the waves emana­ting from Brazil and Indonesia in 1964 and 1965.”Vincent Bevins writes in The Jakarta Method

While Indonesia is a focus of the book, the narra­tive stretches far beyond the country’s borders, detailing CIA-backed regime changes across vast swathes of the world.

Bevins suggests the US-backed dictatorship in Brazil, which took power in a coup in 1964, played a crucial role in pushing the rest of South America into the anti-communist group of nations. “I came to the conclusion that the entire world, and especially the countries of Asia, Africa, and Latin America, … has been reshaped by the waves emana­ting from Brazil and Indonesia in 1964 and 1965,” he writes. These two events “led to the creation of a monstrous inter­national network of extermination – that is, the systematic mass murder of civilians – across many more countries”.

Communist parties elsewhere could not fail to take note, with some adopting a more militant attitude perhaps in response to the right-wing threat.

The Jakarta Method offers an easily digestible chrono­logy of this bloody period of Indonesian and world history. While at times the narrative can be too systematic, and lacking in prose that would bring it more to life, the result is a powerful reminder that in many countries around the world, the Cold War was anything but cold, and those that suffered the most were often ordinary people.

In one of the most revealing passages of the book, Bevins describes how eyewitnesses and victims, all these years later, talk about that period in terms of weeks, specific dates, hours, even minutes. The trauma and suffering are still raw, made worse by a lack of public discussion and closure.

As much as the brutal methods were abhorrent, Bevins admits they were effective. “I am not saying that the United States won the Cold War because of mass murder,” he writes, but adds that the extermination programmes in countries such as Indonesia, “organised and justified by anti-communist principles”, was such an important part of the US victory that the violence profoundly shaped the world we live in today.


It is a sobering thought.

Read more

The Road: Indonesia’s 50-year forgotten war in West Papua

Here’s The Grisly Details On The Most Devastating And Deadly Plagues, Pandemics, and Epidemics in History
 April 26, 2020 By Paige Steinman

Flickr/Scanpix

As the World Economic Forum notes: “Throughout history, as humans spread across the world, infectious diseases have been a constant companion.” While some of these diseases come and go, others have left the world in turmoil and tens of millions dead. Here’s a grisly in-depth look at some of the deadliest, most devastating epidemics and pandemics of all time, how they spread, and the havoc they wreaked.

1. Antonine Plague (165-180)

When the Roman army returned from their siege of ancient Mesopotamia in 165, they may have achieved a military win. But that victory came with a lot of losses in the aftermath, thanks to the germs the soldiers brought back with them. In total, five million people died during the Antonine Plague not only in the Roman Empire, but across the Mediterranean region.


Nicholas Poussin/Wikimedia Commons

While no one is exactly sure what the disease itself was, many historians guess it was a strain of measles or smallpox. When the plague began, the Roman Empire was at the height of their power. By the end, the unknown disease had killed millions of Romans, and the ranks of the once-mighty Roman military had been decimated.





2. Plague of Justinian (541-542)

To imagine the Plague of Justinian happening today would be like picturing the apocalypse happening right in front of our eyes. An astounding 25 million people (at minimum) died from this early pandemic, killing 10 percent of the entire world’s population and one-fourth of the total population living in the Eastern Mediterranean region.


Josse Lieferinxe/WIkimedia Commons

The plague’s epicenter was in Constantinople, the capital of the Byzantine Empire at the time, and was named for the Byzantine emperor himself, who managed to survive the disease. At its peak, the Plague of Justinian is believed to have killed 5,000 people in the city every single day. There was no infrastructure to support this amount of death, so corpses would sometimes be placed in the streets or in empty buildings.





3. Black Death (1347-1351)

There’s a reason the Black Death, otherwise known as the Great Bubonic Plague, remains so infamous. With jaw-dropping speed and fatality, it claimed the lives of up to 200 million people over just four years. Entire populations of towns were completely obliterated, and the dead often had to be tossed into mass graves.



Pep Roig/Alamy Stock Photo

While the Black Death hit Europe the hardest, this strain of plague is thought to have originated in Asia. The disease reportedly spread because merchants often traveled back and forth between the continents. Unbeknownst to them, as they carried with them on board goods to sell, hitching a ride were the flea-infested rats responsible for transmitting the illness.





4. New World Smallpox Outbreak (1520-1902)

While Europeans had generations to build up a natural immunity, when European explorers entered the “New World” of the Americas, the smallpox they brought with them was absolutely catastrophic to communities living there. For example, by the time the Pilgrims landed in Massachusetts, it’s estimated that 90% of local peoples had already died of smallpox germs that had traveled north from Spanish colonies. By then, nearly the entire native population of Central and South America had succumbed.



Smith Collection/Gado/Getty Images

In total, over 56 million people across the Americas died as a result of smallpox. Mexico’s population crashed from around 11 million before European arrival to just one million. As it spread south, the disease was credited with weakening the Aztec and Inca Empires even before Spanish conquest. Smallpox is ancient, as evidenced from signs on 3,000-year-old Egyptian mummies, and eventually was the first pandemic to be eradicated via vaccination.





5. Italian Plague (1629-1631)

Long after the Black Death had ended, the same viral strain popped up again after troops returned home to Italy from the Thirty Years’ War. And this time, Italy would lose about 1 million of its residents. This deadly pandemic in Italy caused those who were infected to have to stay in sick houses and burn all of their possessions out of fear.



Dea Picture Library/De Agostini via Getty Images

This period also gave rise to the now-iconic plague doctors, who were paid by the city to treat everyone regardless of their wealth. These doctors famously wore a black overcoat, along with a bizarre, macabre mask featuring glass eye openings and a beak-like nose. Unfortunately, many of these doctors had little to no training, and more often than not, their patients would die.





6. Great Plague of London (1665-1666)

In the centuries following the Black Death, the bubonic plague sprang up a few more times throughout Europe, but the capital of England was the hardest hit during the Great Plague of London in 1665. During that time, 100,000 Londoners died in just seven short months. Throughout London, one of Europe’s largest cities even then, every resident was quarantined and public events were banned.



Archive Photos/Getty Images

As the wealthy fled their London homes for the countryside, the poor were left to suffer the losses. All homes where a family member was sick had to be marked with a red cross painted on their doors. As animals beyond just rats were rumored to have carried the disease, many families had to put down their livestock and pets during this tragic time.


7. Yellow Fever (1793)

In 1793, Philadelphia was the capital of the United States, and it was facing a major health crisis. In a short period of time, 5,000 people in just that city alone had died, and thousands had met a similar fate across the Eastern United States due to yellow fever.



Corbis via Getty Images

Researchers at the time knew that this outbreak had been caused primarily by mosquitoes. Because of this, they also believed that slaves who had been sent over from Africa had an immunity to this illness. Female slaves were sent to work in hospitals. In total, 100,000 to 150,000 people died of the disease during the hot summer of 1793. The epidemic only ended when the winter months killed off the mosquitoes.





8. Cholera Pandemics 1-6 (1817-1923)

In the 19th and 20th centuries, six different waves of cholera pandemics surged across the globe. They wreaked havoc throughout Asia, Europe, North America, and Africa, and cost the lives of over 1 million people worldwide. The disease’s cause, now widely-known to be caused by contaminated and unsafe food and drinking water, managed to stump researchers for a long time.



Bettmann/Getty Images

That was until the English doctor John Snow began studying the infections throughout mid-19th century England. Dr. Snow traced 500 fatal cases to one area surrounding the Broad Street water pump in London’s West End, where much of the city got its drinking water. Once a piece was removed, cases in that area cleared up, and scientists began to realize that contaminated water was a vector. However, it would be nearly a century before cholera pandemics ceased spreading.





9. Third Plague (1855)

Over time, the Plague of Justinian became known as the First Plague and the Black Death was often referred to as the Second Plague. But in 1855, a new pandemic sweeping across the world killed 12 to 15 million people, landing itself a place in notoriety with its name, the Third Plague.



Hulton Archive/Getty Images

This pandemic originated in Yunnan Province in southern China and ravaged both China and India, but quickly spread to every inhabited continent in the world. The disease was thought to have been caused by fleas found on rats, and just as the Black Death had traveled, it spread as these rats stowed away on cargo ships from one country to the next. That theory was later proven in 1894.


10. Russian Flu (1889-1890)

For many of the plagues and flues that came before, the world’s population was relatively safe because travel was not very easy. When these viruses spread in the past, it was largely because of cargo ships. That all changed with the arrival of the late-19th century pandemic called the Russian flu or the Asiatic flu.


Library of Congress/Corbis/VCG via Getty Images

This virus includes Russia in its name because at that time the Russian Empire had significantly built up its railroads, causing the disease to spread rapidly within a matter of days as people traveled. By the time it ended, it had killed approximately 1 million people, and became known as the last major pandemic of the 19th century.





11. Spanish Flu (1918-1920)

The First World War had devastated a generation — and then, even before it had ended, along came the Spanish flu. In total, an estimated 500 million people became infected. About one-fifth of those infected, about 40 to 50 million people, died due to the illness. But while it holds the name Spanish flu, this deadly strain of influenza did not start in Spain at all.



Library of Congress/Interim Archives/Getty Images

During World War I, Spain was one of the few neutral nations, and therefore had a free press that did not censor its news. As the flu spread throughout the country, infecting even the king, the Spanish press was one of the few outlets able to freely publish its startling death tolls. This led many in the world to think that the epicenter was in Spain, though in reality, this flu had spread all over the world.





12. Asian Flu (1957-1958)

The pandemic now known as the Asian flu was an influenza strain that the world had not yet seen before. The H2N2 subtype of influenza A spread quickly. Its first outbreak was traced back to the Guizhou Province in China, and the disease had spread to Singapore by February of 1957.



Flickr/Scanpix

By April that same year, Hong Kong was experiencing an outbreak, and by the summer of 1957, the Asian flu had reached the shores of the United States. Estimated death tolls vary, but are usually said to be between 1.1 and 2 million, with over 69,000 deaths occurring in the United States alone.





13. Hong Kong Flu (1968-1970)

The Hong Kong flu began, as the name would show, in Hong Kong, but this dangerous strain of H3N2 influenza A traveled quickly. The first case ever reported was recorded on July 13, 1968. Just 17 short days later, there were outbreaks popping up elsewhere in East Asia, in countries such as Singapore and Vietnam.



Bettmann/Getty Images

From there, the virus continued to spread throughout the Philippines, as well as infecting populations in India, Australia, Europe, and parts of the United States. Over the following few years, 1 million people died as a result, including about 500,000 people in Hong Kong, which accounted for about 15 percent of Hong Kong’s total population.





14. HIV/AIDS (1981-present)

The first official case of HIV/AIDS was identified in the Democratic Republic of the Congo in 1976. From there, this truly devastating pandemic has gone on to claim the lives of an estimated 35 million people worldwide. In 1980s and 1990s, the disease had reached a peak in the United States, disproportionately affecting the country’s gay and black communities.



Mark Peterson/Corbis via Getty Images

As there was no cure for decades, along with much governmental failure to adequately respond, the epidemic wiped out nearly an entire generation of gay men. While a “drug cocktail” was finally developed and brought the mortality rate down, there are still an estimated 31 to 35 million people living with HIV, most of whom reside in Sub-Saharan Africa.





15. SARS (2002-2003)

Severe acute respiratory syndrome, otherwise known as SARS, was first identified in November 2002 in China. The first “super-spreader” of SARS is believed to have been a Chinese fisherman who spread the disease to 30 nurses and doctors. And from this group, the virus quickly spread to Hong Kong, Vietnam, Canada, Taiwan, Singapore, and other parts of the world.



Joel Nito/AFP via Getty Images

At the time of the outbreak, China was criticized not only for its slow response to SARS, but also for not being very forthcoming with information related to deaths and infections. By the time the outbreak was finally contained, it had infected 8,000 people and killed nearly 800.





16. Swine Flu (2009-2010)

Swine flu was given its name because this particular strain of influenza had genetic features very similar to the type that affects pigs. Never before witnessed affecting humans, in 2000 the virus began to emerge in Mexico, causing devastation in its wake as it spread across the planet.



Alfredo Estrella/AFP via Getty Images

In just one year, an estimated 200,000 people died due to swine flu, and as many as 1.4 billion people became infected. Unlike many other flu strains, this particular flu affected young people much more frequently than those over the age of 65. After this breakout, a vaccine was developed that is now regularly administered.





17. Ebola (2014-2016)

Ebola was one of the first, if not the first, epidemic to have played out during a 24-hour news cycle. Because of this, as the story spread almost as fast as the disease itself, millions of people watched the devastating effects of ebola from their TV screens, while those living in West Africa had to watch it unfold first hand.




John Wessels/AFP via Getty Images

Ebola was not a new phenomenon. But during this particular ebola outbreak, the deadliest in history, 11,315 people died in six West African countries just 21 months after the epidemic was declared. The virus killed about 66 percent of the people it infected, turning a diagnosis into somewhat of a death sentence. In the years since, the World Health Organization has declared the region ebola-free, only for new cases to pop up almost immediately.





18. MERS (2015-Present)

Middle East respiratory syndrome, also known as MERS, was first discovered in 2012 in Saudi Arabia, giving this particular virus its name. But it took years before this strange new virus began to spread. But its travel path, although not as large as other epidemics, was deadly. For every 50 people infected with MERS, about 17 died.



Chung Sung-Jun/Getty Images

The virus, which was thought to have been passed on through infected camels, was most common in Saudi Arabia. In that country alone, 1,030 people were infected and 453 died, a roughly 44 percent fatality rate. The second most-affected country was far away in South Korea, which saw 182 cases. In total, 850 people passed away from MERS during the outbreak.





19. Zika Virus (2015-2016)

What made Zika virus so terrifying was that it did not seem to affect adults or children as much as it affected infants who were still in the womb, the most defenseless. The virus, linked to infected mosquitoes, caused thousands of babies across South and Central America to be born with underdeveloped brains, neurological problems, and small misshapen heads.



Christophe Simon/AFP via Getty Images

The outbreak became so horrifying and was spreading so rapidly that women in places like Brazil were warned to delay any pregnancies. Women across the world who were pregnant or hoped to soon be pregnant were advised not to visit affected countries.





20. COVID-19 (2019-Present)

COVID-19, also referred to as Coronavirus, first began in Wuhan Province in China, but before long the entire world was feeling its crippling effects. What first started as a lockdown in Wuhan quickly turned the world into one continuous ghost town, with nearly every town and city in the world shut down for business as the virus spread.



Flickr/A Great Reckoning

Entire countries closed down for business and people were told not to leave their homes beyond absolute necessities, let alone without face masks. The number of cases and the death toll continued to climb with numbers nearly rivaling the Spanish flu. Chinese wet markets were once said to be the cause of COVID-19, though other research has disputed those claims leaving this global pandemic somewhat of a mystery.

Sources: World Economic Forum, CNN, CDC

Plague and Spanish flu shaped our world – will the  Coronavirus pandemic as big an impact?

The Black Death killed as many as half of all Europeans and the worst influenza pandemic claimed the lives of up to 100 million people

Both fundamentally changed the fabric of societies. Will historians say the same about Covid-19?

Charles C. Mann Published:14 Jun, 2020

In 2008, a young economist named Craig Garthwaite went looking for sick people. He found them in the National Health Inter­view Survey (NHIS). Conducted annually by the United States Census Bureau since 1957, the NHIS is the oldest and biggest continuing effort to track Americans’ health.

The survey asks a large sample of the citizenry whether they have a variety of ailments, including diabetes, kidney disorders and several types of heart disease. Garthwaite sought out a particular subset of respondents: people born between October 1918 and June 1919.

Those months were the height and immediate after­math of the world’s worst-ever influenza pandemic. Although medical data from the time is too scant to be definitive, the first case is generally said to have been in Kansas in March 1918, as the US was stepping up its involvement in World War I.

In a flurry of wartime propaganda, American and European governments downplayed the epidemic, which helped it spread. Estimates of the final death toll range from 17 million to 100 million, depending on assumptions about the number of uncounted victims. Almost 700,000 people are thought to have died in the US – as a proportion of the population equivalent to more than two million people today.

An announcement from the Illustrated Current News dated October 18, 1918, offering tips for how to stop the spread of influenza. Photo: National Library of Medicine

Remarkably, the calamity left few visible traces in American culture. Writers Ernest Hemingway, William Faulkner and F. Scott Fitzgerald saw its terrible effects first-hand, but almost never mentioned it in their work. Nor did the flu affect US policies – Congress didn’t even allocate extra money for flu research afterwards.

Just a few decades after the pandemic, American-history textbooks by the distinguished likes of Arthur M. Schlesinger Jnr, Richard Hofstadter, Henry Steele Commager and Samuel Eliot Morison said not a word about it. The first history of the 1918 flu wasn’t published until 1976. Written by the late Alfred W. Crosby, the book is called America’s Forgotten Pandemic.

Americans may have forgotten the 1918 pandemic, but it did not forget them. Garthwaite matched NHIS respon­dents’ health conditions to the dates when their mothers were probably exposed to the flu. Mothers who got sick in the first months of pregnancy, he discovered, had babies who, 60 or 70 years later, were unusually likely to have diabetes; mothers afflicted at the end of pregnancy tended to bear children prone to kidney disease. The middle months were associated with heart disease.



Other studies showed different consequences. Children born during the pandemic grew into shorter, poorer, less educated adults with higher rates of physical disability than one would expect. Chances are that none of Garthwaite’s flu babies ever knew about the shadow the pandemic cast over their lives. But they were living testaments to a brutal truth: pandemics – even forgotten ones – have long-term, power­ful after-effects.

The distinguished historians can be forgiven for passing over this truth. Most modern people assume that our species controls its own destiny. “We’re in charge!” we think. Being modern people, historians have had trouble, as a profession, accepting that brainless packets of RNA and DNA can capsize humankind in a few weeks or months.

The convulsive social changes of the 1920s – the frenzy of financial speculation, the resurgence of the Ku Klux Klan, the explosion of Dionysian popular culture (jazz, flappers, speakeasies) – were easily attributed to the war, an initiative directed and conducted by humans, rather than to the blind actions of microorganisms. But the micro­organisms likely killed more people than the war did. Their effects spread across the globe, emptying city streets and filling cemeteries on six continents.

Unlike the war, the flu was incomprehensible – the virus wasn’t even identified until 1931. It inspired fear of immi­grants and foreigners, and anger towards the politicians who played down the virus. Like the war, influenza (and tuberculosis, which subsequently hit many flu sufferers) killed more men than women, skewing sex ratios for years afterwards. Can one be sure that the ensuing, abrupt changes in gender roles had nothing to do with the virus?

We will probably never disentangle the war and the flu. But one way to summarise the impact of the pandemic is to say that its magnitude was in the same neighbourhood as that of the “war to end all wars”.

Claims about the Black Death’s origin invoked “floods of snakes and toads, snows that melted mountains, black smoke, venomous fumes, deafening thunder, lightning bolts, hailstones and eight-legged worms that killed with their stench”. Photo: Shutterstock

Nobody can predict the consequences of today’s pandemic. But
history can tell us a little about what kind of landscape we are approaching.

Consider the Black Death. Sweeping through Europe from about 1347 to 1350, the plague killed somewhere between a third and half of all Europeans. In England, so many people died that the population didn’t climb back to its pre-plague level for almost 400 years.

With the supply of workers suddenly reduced and the demand for labour relatively unchanged, medieval land­owners found themselves in a pickle: they could leave their grain to rot in the fields, or they could abandon all sense of right and wrong and raise wages enough to attract scarce workers.

In northern Italy, landlords tended to raise wages, which fostered the development of a middle class. In southern Italy, the nobility enacted decrees to prevent peasants from leaving to take better offers. Some historians date the separation in fortunes of the two halves of Italy – the rich north, the poor south – to these decisions.

When the Black Death began, the English Plantagenets were waging a long, brutal campaign to conquer France. The population losses meant such a rise in the cost of infantrymen that the whole enterprise foundered. English nobles did not occupy French chateaux. Instead they stayed home and tried to force their farmhands to accept lower wages. The result, the Peasants’ Revolt of 1381, nearly toppled the English crown. King Richard II narrowly won out, but the monarchy’s ability to impose taxes, and thus its will, was permanently weakened.

An illustration by James William Edmund Doyle shows England’s King Richard II meeting rebels during the Peasants’ Revolt in 1381. Photo: Getty Images

Nobody thinks the coronavirus will kill anywhere near as many people as the Black Death did. A shortage of labour due to corpses piling up in the streets will not cause wages to rise. Even so, the new virus has been a shock to society. The plague struck a Europe that was used to widespread death from contagious disease, especially among children. The coronavirus is hitting societies that regarded deadly epidemics as things of the past, like whalebone corsets and bowler hats.

When I went to college, in the 1970s, pre-med students carried around a fat textbook co-written by the Nobel Prize-winning virologist Macfarlane Burnet. “The most likely forecast about the future of infectious disease,” it sunnily concluded, “is that it will be very dull.”

Such optimism was not exceptional. A few years later, Robert Petersdorf, a future president of the Association of American Medical Colleges, contemplated the current crop of MDs seeking certification in infectious disease and said, “I cannot conceive of a need for 309 more infectious-disease experts unless they spend their time culturing each other.”

When Aids came into the world, disease researchers reconsidered, loudly warning of new pandemics. Journalists wrote books with titles such as The Coming Plague and Spillover: Animal Infections and the Next Human Pandemic.

But not many non-scientists took these warnings to heart. The public has not enjoyed its surprise re-entry into the world of contagion and quarantine – and this unhappiness seems likely to have consequences.

Demonstrators protest the inflated prices charged by pharmaceutical companies for Aids treatment drugs, in 1997. Photo: AFP
Scholars have long posited that the shattering of norms by the Black Death was the first step on the path that led to the Renaissance and the Reformation. Neither government nor Church could explain the plague or provide a cure, the theory goes, leading to a crisis in belief. Secular and religi­ous leaders died just like common people – the Black Death killed the archbishop of Canterbury, Thomas Bradwardine, a mere 40 days after he assumed office. People sought new sources of authority, finding them through direct personal experience with the world and with God.

To some extent, all of this is surely true. The plague came in waves, and after each wave doctors, clerics and chroni­clers speculated about the causes and described the treatments they had seen deployed.

As the University of Glasgow historian Samuel Cohn Jnr has shown, the early claims about the plague’s origin invoked “floods of snakes and toads, snows that melted mountains, black smoke, venomous fumes, deafening thunder, lightning bolts, hailstones and eight-legged worms that killed with their stench”. Some writers blamed the poor: their fecund­ity, their improvidence, their sinfulness. Others pointed fingers at that ever-ready European bogeyman, the Jew.

Scared Europeans sought favour from the heavens, most famously taking off their clothes in groups and striking one another with whips and sticks. Images of half-nude flagellants have, since Monty Python, become a comic staple. Far less comical was the accompanying flood of anti-Semitic violence. As it spread through Germany, Switzerland, France, Spain and the Low Countries, it left behind a trail of beaten cadavers and burned homes.

Within a few decades, Cohn wrote, hysteria gave way to sober observation. Medical tracts stopped referring to conjunctions of Saturn and prescribed more earthly cures: ointments, herbs, methods for lancing boils. Even priestly writings focused on the empirical. “God was not mentioned,” Cohn noted. The massacres of Jews mostly stopped.

A protester holds up a placard with a message against Bill Gates, during a demonstration against the lockdown imposed to slow down the spread of the coronavirus, in Berlin, Germany, in April. Photo: Reuters
It’s easy to see this as a comforting parable of rationality winning out over the engines of rumour, prejudice and superstition, ultimately leading to the Renaissance and the Enlightenment. But the lesson seems more that humans confronting unexpected disaster engage in a contest for explanation – and the outcome can have consequences that ripple for decades or centuries.

And the contest for explanation is well under way – Donald Trump is to blame, or Barack Obama, or the Centres for Disease Control and Prevention, or China, or the US military’s biowarfare experiments, or Bill Gates. Nobody has yet invoked eight-legged worms. But in our age of social media, rumour, prejudice and superstition may have even greater power than they did in the era of the Black Death.

Christopher Columbus’ journey to the Americas set off the worst demographic catastrophe in history. The indigenous societies of the Americas had few diseases – no smallpox, no measles, no cholera, no typhoid, no malaria, no bubonic plague. When Europeans imported these diseases, it was as if all the suffering and death these ailments had caused in Europe during the previous millennia were compressed into 150 years.

Up to nine-tenths of people in the Americas died. Many later European settlers believed they were coming to a vacant wilderness. But the land was not empty; it had been emptied – a world of loss encompassed in a shift of tense.

Absent the diseases, it is difficult to imagine how small groups of poorly equipped Europeans could have survived in the alien ecosystems of the Americas. “I fully support banning travel from Europe to prevent the spread of infectious disease,” the Cherokee journalist Rebecca Nagle remarked after Trump announced his plan to do this. “I just think it’s 528 years too late.”

Members of the Red Cross Motor Corps wear masks while transporting a patient in St Louis, Missouri, in October 1918. Photo: Getty Images

For Native Americans, the epidemic era lasted for centuries. Isolated Hawaii had almost no bacterial or viral disease until 1778, when the islands were “discovered” by British explorer James Cook. Islanders learned the cruel facts of contagion so rapidly that by 1806, local leaders were refusing to allow European ships to dock if they had sick people on board.

Nonetheless, Hawaii’s king and queen, Kamehameha II and Kamamalu, travelled from their clean islands to London, that cesspool of disease, arriving in May 1824. By July they were dead – measles.

The royals had gone to Britain to negotiate an alliance against the US, which they correctly believed had designs on their nation. The monarch’s successor, 12-year-old King Kamehameha III, could not resume the talks. The results changed the islands’ destiny. Undeterred by the British Navy, the US annexed Hawaii in 1898. Historians have seldom noted the connection between measles and the presidency of Obama.

As a rule, epidemics create what researchers call a “U-shaped curve” of mortality – high death rates among the very young and very old, lower rates among working-age adults. (The 1918 flu was an exception; a disproportionate number of twenty-somethings perished.) For Native peoples, the U-shaped curve was as devastating as the sheer loss of life.

As an indigenous archaeologist once put it to me, the epidemics simultaneously robbed his nation of its future and its past: the former, by killing all the children; the latter, by killing all the elders, who were its storehouses of wisdom and experience.

I have no idea what the ultimate effects of the corona­virus will be, but I hope that they will be like those of the 2003 Sars epidemic in Hong Kong. That epidemic, which killed 299 people in the city, was stopped only by heroic communal efforts

For reasons as yet unknown, the U-shaped curve does not apply to today’s coronavirus. This virus largely (but not entirely) spares the young and targets the old. Terrible stories of it
sweeping through nursing homes reinforce this impression, especially if, like me, you’ve lost a relative in one. The result will be, among other things, a test of how much contemporary society values the elderly.

So far, the evidence suggests: not much. The speed with which pundits in the US emerged to propose that it could more easily tolerate a raft of dead oldsters than an econo­mic contraction indicates that the reservoir of appreciation for today’s elders is not as deep as it once was. This change may reflect another: today’s old are older than the old of the past, when lifespans were shorter.

Past societies mourned the loss of collective memory caused by epidemics. Ours may not, at least at first.I have no idea what the ultimate effects of the corona­virus will be, but I hope that they will be like those of the 2003 severe acute respiratory syndrome (Sars) epidemic in Hong Kong. That epidemic, which killed 299 people in the city, was stopped only by heroic communal efforts.

Everyone in Hong Kong knows the city dodged a bullet. Or it seems that way when I visit. My work has taken me there, off and on, since 1992. In a city that once resounded with smokers’ coughs, people now don masks at the first sign of a cold. Omnipresent signs – in hotel lifts, on con­veni­ence-store doors, in office waiting rooms – describe how often their locations are disinfected. An amazing number of people wear surgical gloves to serve food, handle papers, even push lift buttons.

Hongkongers in Central during the 2003 Sars outbreak. Photo: AFP


These measures may suggest a community in the grip of fear. But the masks and signs and gloves seem more like the “victory gardens” outside homes during World War II – cheerful public notices of people doing their part. Most important, Hong Kong may have contained Covid-19 faster than any other place in the world.

I was there during last autumn’s protests. At one point, I found myself near a university at the centre of the unrest. Almost nobody was outside and the shops were closed. There was a lot of debris and smoke. As I stood there, befuddled, a man ran out of a convenience store and pulled me inside. “The police are coming,” he said. “Very dangerous!”

Inside was a cross section of Hong Kong citizens – young and old, trainers and salaryman shoes, quite a few in makeshift masks. I thanked the proprietor for rescuing me from what could have been an unpleasant encounter. “We are all here together,” someone said.

Later it occurred to me that a possible legacy of Hong Kong’s success with Sars is that its citizens seem to put more faith in collective action than they used to. I’ve met plenty of Hongkongers who believe that the members of their community can work together for the greater good – as they did in suppressing Sars and will, with luck, keep doing with Covid-19. It’s probably naive of me to hope that containing the coronavirus would impart some of the same faith elsewhere, but I do anyway.

Financial support for this article was provided by the HHMI Department of Science Education.

Text: The Atlantic Magazine

Charles C. Mann is an American journalist and author, specialising in scientific topics.

‘If you catch it, don't spread it to others’, 1949 flu advice still applies to coronavirus pandemic

Disease

How disease has fed on China’s progress – shift from nomadic hunters to farming communities sowed the seeds for millennia of sickness

From malarial neolithic settlements on the Yellow River plain to the plague-ravaged Mongols and today’s host-jumping pathogens, disease has long helped to shape China

Thomas Bird Published: 24 May, 2020


In 1999, while most people were anticipating what the new millennium might bring, American academic Jared Diamond cast his gaze back 10,000 years to question whether the agricultural revolution that had germinated settled society had really been such a great leap forward.

Writing in Discover Magazine, Diamond contended, “With agri­culture came the gross social and sexual inequal­ity, the disease and despotism, that curse our existence.” Significantly, epidemics that “couldn’t take hold when populations were scattered in small bands that constantly shifted camp” spread only after humans began to grow crops and raise chickens. “Tuberculosis and diarrheal disease had to await the rise of farming; measles and bubonic plague the appearance of large cities.”

Yet for the Chinese, the idea that agriculture was the wellspring of civilisation is seldom, if ever questioned.

From the revolutionaries that settled the Yellow River valley thousands of years ago, Chinese history is often framed with Long March gallantry, leading step by step from paddy field to palatial shopping centre. Chinese civilisation, the story goes, outlasted all its rivals and triumphed over the vagaries of nature, stoically enduring episodes of turmoil to arrive at the current age of abundance. It is a tale of great and ongoing struggle, soaked in blood, sweat and jingoism.

Since AD200-250, traditional Chinese medicine has harnessed all aspects of life, from food to sex. (Illustration from G.N. Wright’s 1843 book, China, In a Series of Views, Displaying the Scenery, Architecture, and Social Habits, of That Ancient Empire.) Photo: Getty Images

But what if it was the millet first planted by China’s neolithic ancestors that sowed the seeds for centuries of untold misery?

Like those of ancient Greece, China’s origin myths were created in hindsight and reflect a preordained greatness to come. Shennong, the god of agriculture, taught the Chinese to farm, while his successor, Huangdi, the Yellow Emperor, symbolically battled his rival Chiyou for control of the hazardous Yellow River, from whose surroundings would grow the very idea of China as we know it.

As far back as records go, we know the Yellow River was a capricious mistress. Its lethal capacity to shift course without warning, causing massive floods accompanied by famine and disease, prompted author Philip Ball to remark in The Water Kingdom (2016), “it’s hard to imagine how anyone, let alone millions, endured it routinely”.

The river’s propensity for disaster continued until the modern era. In 1887, as many as 2.5 million people were killed by floods or related diseases such as typhoid. And yet, along its muddy banks in about 7500BC – at roughly the same time the Fertile Crescent was being settled in the Middle East – neolithic societies decided to make a go of it as farmers. By 2070BC, a state had emerged: the mysterious Xia people.

We don’t know much about Xia society but evidence suggests bean curd, fruits such as oranges and peaches, and animal husbandry were established means of food production for the pioneer Chinese state. But living in settlements meant the Xia – followed by the Shang and Zhou dynasties – unearthed “snakes” and “dragons” from the Yellow River plain, or what Mary Dobson in Murderous Contagion (2014) dubs “ancient maladies” like malaria and schistosomiasis.

The latter is caused by parasitic flatworms that “became a significant human infection in river valleys such as the Euphrates, the Nile in Egypt and the Yellow (Huang He) River in China, when people began to settle, farm and irrigate the land”.

Living in proximity to domesticated animals put people in range of other invisible enemies, as Yuval Noah Harari outlines in Sapiens (2011): “Most of the infectious diseases that have plagued agricultural and industrial societies (such as smallpox, measles and tuberculosis) originated in domesticated animals and were transferred to humans only after the Agricultural Revolution.”

Evidence for this can be found in the 3,000-year-old Chinese character jia, meaning “home” and “family”, which is represented by a pig in a house. A typical Shang dynasty household would have lived cheek-by-jowl with their live­stock, oblivious to the dangers this arrangement posed.

A 1907 illustration in Paris’ Le Petit Journal shows cholera victims in China and government officials being mobbed by starving people. Photo: Getty Images
A host of “lifestyle diseases” afflicted the Chinese, too. From sunrise to sunset, toiling farmers were weakened by “slipped discs, arthritis and hernias”, writes Harari, ailments unknown to hunter-gatherers who “spent their time in more stimulating and varied ways, and were less in danger of starvation and disease”. Nomadic and semi-nomadic peoples, such as the Xiongnu, Toba, Khitan and Mongols – to name but a few “barbarian” peoples given to pillaging China – would know little of such maladies.

As the Chinese had committed themselves to the land, they couldn’t abandon their pastures and ride off into the sunset, as their enemies invariably did. So while rationalist culture and philosophical debate evolved in the open city of Athens, on the other side of the world, the Chinese began to wall themselves in, a mode of defence that was well under way by the latter half the Eastern Zhou dynasty (770-256BC).

Every siheyuan, or quadrangle courtyard house, would have its “garden” or social space located inside; every village, town and city would be ringed with rammed earth or stone. Even the imperial frontier would be demarcated by the Great Wall, the earliest version of which dates back to 300BC and the Zhao State, according to wall historian William Lindesay. Only in the 20th century did China begin to demolish its city ramparts.

These barriers helped slow the progress of China’s external enemies, but made the enemy within harder to contain. As Harari writes, “most people in agricultural and industrial societies lived in dense, unhygienic permanent settlements – ideal hotbeds of disease”. Thus China was forced to fight a protracted campaign on two fronts, against invading steppe peoples and the baibing (100 diseases): both microbe and marauding Mongols could become a potential regime changer if left unchecked.

The shift from nomadic hunters to settled farming communities sowed the seeds for millennia of disease. Photo: Getty Images

To confront wily tribes, China was able to make war, Diamond writes: “Farming could support many more people than hunting, albeit with a poorer quality of life […] a hundred malnourished farmers can still outfight one healthy hunter.” So the Chinese played the numbers game, unaware the imperial granaries hid a Malthusian trap – unchecked population growth versus a static food supply.

As early as 1300BC, Anyang, in Henan province, was the biggest city in the world. By the Tang dynasty (AD618-907) Chang’an (modern Xian) was home to more than a million people. Han China (202BC-AD220) was more populous than its Western contemporary, the Roman Empire.

Running low on space, farmers “crept over the face of China like a skin rash”, as travel writer Bruce Chatwin put it, settling further and further from their Yellow River homeland, and often within range of steppe nomads or southern barbarians – the Baiyue, meaning 100 yue, or peoples. Though famine, disease and war occasionally levelled the population, a period of peace or a new innova­tion, such as the introduction of counter-cyclical New World crops like corn and potatoes during the Qing dynasty (1644-1912), saw numbers rise over time.

Just as Europeans sent their excess population to the colonies of the New World, the Chinese, too, were forced to “colonise” fresh pastures. They sailed across the straits to Taiwan, intruded on the Tibetan plateau, crept northeast into Manchuria and southwest into the tribal lands of Yunnan and Guizhou, displacing indigenous peoples and forging the ethnic and political tensions of today. But unlike Europeans, who took lethal germs to the Americas, the Chinese often found themselves contracting new indigenous diseases, especially in the tropical south.

The Mawangdui medical texts demonstrate the Han aristocrats’ obsession with preserving health, avoiding disease, and living life to the fullestRuth Rogaski, scholar

Agriculture may not have brought a better life for the average Zhou, but it did bring surplus, which as Diamond points out, fed a class society. China’s pampered elites congregated in great urban centres – Chang’an, Luoyang and, later, Beijing – from where they sought to manage their expansive realm. They imposed strict rules on their subjects, such as
the nightly imperial curfew.

But these security measures only helped make Chinese settlements hotbeds for “crowd diseases” such as smallpox and measles. Besides the poisoning and assassinations that were the stuff of court politics, disease remained an emperor’s biggest threat. By the time of the Han dynasty, the literate Chinese had amassed the greatest canon of medical texts in the world.

“Among the earliest extant medical texts are those recovered from the Mawangdui tomb (sealed 168BC) in present-day Hunan,” writes scholar Ruth Rogaski in her 2014 book Hygienic Modernity. “The Mawangdui medical texts demonstrate the Han aristocrats’ obsession with preserving health, avoiding disease, and living life to the fullest.” The text reads like the advice of a modern health guru, describing, “sexual practices, dietetic regimens, movements and medicines designed to nurture vital forces and ensure the proper flow of qi within the body”.

The Han period, now considered an early “scientific golden era”, also produced a number of famous doctors. Some are revered to this day, such as Hua Tuo, the first to use a general anaesthetic.

The Chinese gave fantastically descriptive names to the “pestilent qi” that afflicted them: “toad fever”, for example, caused the abdomen to swell, and “crab fever” caused small red bumps on the throat.

In a 1922 illustration from Myths and Legends of China, by Edward T.C. Lerner, plague-disseminating umbrellas are defeated by the wave of a magic fan. Photo: Getty Images

With a vocabulary born of Taoism, which advocates harmony with the natural order of the cosmos, traditional Chinese medicine brought together myriad means of “guarding life” (weisheng) and “nurturing life” (yansheng), including meditation and martial arts, sex and sexual abstinence, tea and food, cosmology and herbology. All aspects of life were marshalled to the cause of weisheng zhi dao, the way of guarding life.

Medical quests are a recurring theme in Chinese history, most famously perhaps the unifying emperor Qin Shihuang’s hunt for the elixir of immortality, which saw him order a sea expedition to mythical Penglai Mountain to find a 1,000-year-old magician who held the secrets of longevity. The ship never returned and Qin died two years later, after swallowing mercury pills given to him by the court doctor.

The legend lingered for a millennia and, in 1220, Genghis Khan, having already conquered much of northern China and Eurasia, summoned Taoist master Qiu Chuji from Shandong to his royal camp in present-day Uzbekistan to ask him for the medicine of immortality. Although Qiu did not have the elixir the Great Khan sought, Rogaski writes, “The Daoist master [offered]a regimen that could strengthen the body’s resistance to illness.”

The advice included “a diet harmonised with the seasons” as well as “quiet meditation” and warned against the “dangers of sex”. That pearl of wisdom was conveniently ignored by a man for whom harems, concubines and the rape of enemy wives was the norm. According to an international genetic study published in 2003, the Great Khan may have as many as 16 million descendants living today in the lands of the former Mongol empire.

The hunt for Genghis Khan’s tomb on ‘Mountain X’
20 Jul 2018


But 50 years later, the Mongol Yuan dynasty would be in trouble. The Mongols adapted poorly to sedentary life, preferring to live in tents rather than the palaces of Dadu (Beijing). Despite Kublai Khan’s Confucian pretensions, he continued to banquet like a Mongol, but without hunting he grew from the “well-formed” figure Marco Polo met to an obese ruler afflicted by severe rheumatism and gout. The Mongol aristocrats squabbled, their mastery of siege warfare no apprenticeship for Chinese statecraft and they were resented by the majority Han Chinese.

But what really plagued Yuan China was, well, plague. We don’t know if the virulent strain of bubonic plague that ravaged China in the 1330s was the Black Death that crept into Europe in the 1340s and killed two-thirds of the population, though a similarly horrific mortality rate in China suggests it was.

Fourteenth century Europeans often called it “the pestilence from the East”. Given the timing of the disease, it was likely introduced to China via Himalayan horsemen, then travelled down the recently opened Silk Road. Hubei province lost 90 per cent of its population, according to historian Jonathan Fenby. Plague and other epidemics saw the population decline under the Mongols from an estimated 110 million to 85 million by the time they lost power, in 1368, after a series of popular uprisings against China’s ancient foes: nomads and disease.
The early Ming dynasty that followed was a prosperous period epitomised by the voyages of
Admiral Zheng He, who famously sailed the South China Sea and Indian Ocean projecting Chinese state power to the known world. But as during any stable epoch, the population spiked, a rise accompanied by frequent outbreaks of measles and smallpox.

Plague inspectors in Hong Kong in August 1890; the disease broke out in Western district and continued sporadically until the 1920s. Photo: Getty Images

“In 1407, 78,400 died from epidemics in Jiangsu and Fujian provinces alone,” writes Louise Levathes in When China Ruled the Seas (1994). And so Zheng’s fourth expedition had clandestine motives, namely to collect medicinal herbs and cures from the markets of Sumatra, Malacca and Ceylon, and take them back to China to help heal the sick.

When the Portuguese sailed into the same ports less than a century later, they heard stories of the great Chinese fleet that had preceded them. When they arrived in South China, in 1513, the Celestial Kingdom appeared to live up to its lofty reputation. Accounts from the time credit the Chinese with being civil and clean. Adventurer Galeote Pereira wrote, “They feed with two sticks, refraining from touching their meat with their hands, even as we do with forks, for which respect, they less do need any tablecloths. Neither is the nation only civil at meat, but also in conversation and in courtesy they seem to exceed all.”

Such praise helped provoke a mania for chinoiserie in 17th century Europe. Commodities such as fine tea, porcelain and silks helped engender an imagined oriental heaven, free from the suffering of disease-ridden Europe.

When Europeans finally did intrude on China, in the wake of British gunboats at the conclusion of the first opium war, in 1842, their elevated opinion of the Chinese had turned to arrogant contempt. They regarded the Qing empire as being home to godless heathens, dirty and diseased, and “in need of foreign salvation and admini­stration”, as Beijing-based historian Jeremiah Jenne explains the pretext for carving up China.

Superstition was so rife in China that fighters in the 1899-1901 Boxer Rebellion relied on amulets for protection. Photo: Getty Images
The imperial interlopers established sheltered com­munities, often on islands, away from the “natives” who spat and smoked opium, much of which was imported by Europeans. Accounts at the time express revulsion for the smells and “miasmas” endemic to China’s overcrowded cities. Cholera outbreaks were frequent and misery was a virtue to be endured.

The Chinese appeared so burdened by history as to be blind to the light of modernity – slaves to injudicious Manchu overlords and superstitious beyond comprehension. When sick, they prayed at the Medicine King Temple or drank bitter herbal concoctions. They believed sacred amulets could protect the wearer from harm, as evidenced during the catastrophic Boxer Rebellion of 1899-1901, when northern Chinese peasants rose up against Christian missionaries and Western merchants, leading to their wholesale massacre and the sacking of Beijing’s Summer Palace by British and French soldiers.

Feeding the prejudice, two outbreaks of plague in late-Qing China rocked the world. What the Chinese called the “rat epidemic” emerged in 1855 in Yunnan province, where the Han Chinese had been moving in great numbers to mine tin. Ethnic tensions between minority peoples, especially Hui Muslims, and the newly arrived Han, erupted into rebellion. The Qing government sent troops to quash the revolt and they returned infected with the disease. Within weeks, it had killed 60,000 people in Guangzhou, then in 1894, it spread to Hong Kong, Britain’s new global entrepôt.

“From Hong Kong steamships carried the plague bacilli to all the major seaports in the world,” writes Carol Benedict in her 1996 book, Bubonic Plague in Nineteenth-Century China. “In most cases, the disease did not spread further inland, but in India plague claimed some 6,000,000 victims between 1898 and 1908.”

Swiss-French scientist Alexandre Yersin. Photo: Institut Pasteur

Plague would periodically resurface in Hong Kong and India until the 1940s. During what is now dubbed the “third plague pandemic”, in the 19th century, Europeans, North Americans and the Japanese were generating new mecha­nisms to combat illness. This scientific revolution was to liberate mankind from the virulent by-products of settled civilisation. No more leech therapy or bloodletting.

The pioneering work of bacteriologists such as Frenchman Louis Pasteur (1822-95) and German Robert Koch (1843-1910) were giving name and form to human “curses”, not as qi or miasmas, but as germs. By identifying the enemy, humans would learn how to fight it.

With people dying in such large numbers in Asia, the race was on to identify the source of the plague. It was won by Swiss-born bacteriologist Alexandre Yersin, working in a straw hut in Hong Kong. According to Dobson, he “procured cadavers of plague victims to study by bribing English sailors who had the job of disposing of bodies”. In 1894, Yersin identified Yersinia pestis, as the lethal bacteria is now known in his honour.

Japanese scientist Masanori Ogata, working in Taiwan, would suggest rat fleas carried the bacteria, a link proved in 1898 by Frenchman Paul-Louis Simond, working in India. The knowledge that killing flea-infested rats slowed the disease’s spread was critical towards overcoming it.

When plague re-emerged in China in 1910 – this time pneumonic plague, born of trade in marmot fur in Manchuria – and spread along its nascent railway network, taking more than 60,000 lives, it spurred new health care innovations. Malaysian-born, English-trained Chinese doctor Wu Lien-teh introduced quarantine, isolation, limits on travel and face masks to bring the outbreak under control by the following year, according to historian Paul French.

The straw hut “laboratory” in Hong Kong where Yersin identified the Yersinia pestis bacteria, which causes bubonic plague and was named for him. Photo: Institut Pasteur

Wu was a brilliant doctor who helped contain a potential pandemic, as well as equipping us with means to hamper future outbreaks. But racialising disease was infectious and prejudices accompanied the measures to curb disease.

As Dobson writes of plague outbreaks in the late 19th and early 20th centuries, “across the world, ports and cities struggled to contain the disease and the situation was, in many ways, reminiscent of older outbreaks, while also linked to newer issues of imperialism and race […] Blame was attached to certain groups – often, in this case, to immigrants, such as the Chinese …”

In 1882, the draconian Chinese Exclusion Act had wrote Sinophobia into law in the United States, while in Britain, in 1912, a struggling writer using the pseudonym Sax Rohmer and trading on racial stereotypes invented Fu Manchu, an opium-sickened criminal mastermind bent on world domination who would embody “Yellow Peril” for decades to come.
Meanwhile, reformers in China were trading a vision of an ill nation to further their political objectives. The term “Asia’s sick man”, which recently saw
three Wall Street Journal correspondents ejected from Beijing, might have been first applied by late-19th century political philosopher Liang Qichao, who translated Western medical texts as a call to arms against China’s antiquated culture. The lines blurred between individual health and that of the country, as Rogaski writes in Hygienic Modernity: “By creating an ideal West that ‘stresses scientific principles in all aspects of life,’ he creates a deficient China that is mired in superstition and disease.”

Liang would inspire generations of revolutionary reformers, including Sun Yat-sen, the political agitator who became the first president of the republic, in 1912; and writer Lu Xun, who studied medicine in Japan before taking up the pen to heal China’s “spiritual sickness”.

Wu Lien-teh, a Malaysia-born Chinese doctor introduced quarantine, isolation, limits on travel and face masks to bring the 1910 outbreak of plague in China under control. Photo: Handout

After the foundation of the People’s Republic of China, in 1949, the quest for scientific modernity would assume the guise of imperial China’s medical quests, collectivised under socialism. Yet progress was hampered by trouble at the top.

“Mao was almost completely ignorant of modern medicine,” wrote the Great Helmsman’s personal doctor, Li Zhisui, in his 1994 memoir The Private Life of Chairman Mao. “His thinking remained prescientific.” Li’s book tells of how Mao washed his teeth with green tea, believed smoking was a breathing exercise, abused sleeping pills and slept with a harem of young women, his “elixir for a long life”.

Mao might have been ignorant of science but he was well versed in history. Li chronicles Mao’s admiration of some of China’s great tyrants, believing everything under heaven had to be conquered, including nature, as expressed by the ancestors who had first sought to restrain the Yellow River. As Mao’s rule became more despotic, it derailed China’s efforts to modernise, medically or otherwise.

In 1958, Mao introduced the “four pests campaign”, when killing rodents, mosquitoes, flies and sparrows assumed a nationwide patriotic fervour. Yet millions of people would die, not from insect bites or rodent-borne disease but from famine as the Great Leap Forward, designed to pole-vault the country forward, failed spectacularly. Even as peasants perished in the fields, provincial cadres reported record yields, unwilling to challenge Mao’s decree. While China has come a long way since Mao’s time, the chairman casts a long shadow.

“Balance” is a concept embedded in some of China’s earliest efforts to combat disease, from the Taoist recog­ni­tion of cosmic harmony to Han-era doctors who prescribed diets by the seasons. But China’s development of the past four decades has been utterly unbalanced. Cutthroat capitalism driven by utopian Marxism is now leading the country to the precipice. When the sacred threshold between the natural and human world is breached, hostile forces are unleashed – exemplified by a stressed pathogen that jumps hosts.

It’s happened before, when neolithic farmers unearthed parasitic worms from the Yellow River flood plains and when miners settled Yunnan to be greeted by the plague.

The Chinese have been shaped by their history and environment to be at once stoical and versatile. But if the world’s oldest surviving civilisation cannot adopt a more harmonious form, one akin to that propagated by Taoist sages three millennia ago, “the disease and despotism, that curse our existence” will continue to plague China.