With the latest Ebola scare in the U.S. generating news attention and anxiety from coast to coast, a majority of Americans now want to impose a travel ban on the West African countries hardest hit by the virus. Unfortunately, calls for a travel ban draw from America’s long tradition of xenophobia and could be counter-productive to controlling the spread of Ebola in the U.S. and globally. The current fervor for banning travel from African countries such as Liberia, Guinea, and Sierra Leone is based more on fear-mongering than on facts, and is fully in line with this country’s history of using public health as an excuse for racist immigration policies.
The United States has a long and persistent history of conflating immigrants with diseases to determine who to exclude from the country. The Immigration Act of 1891 explicitly excluded from entry all “persons suffering from a loathsome or dangerous contagious disease.” It is no coincidence that this law was enacted at the same time as eugenics theories became popular in the U.S. Public health was used to deem people fit or unfit for admission and citizenship, as it became a convenient excuse to justify discriminatory immigration policies. Lawmakers created new disease categories such as “poor physique,” “presenility,” and “low vitality” as an effective proxy to regulate immigrants on the basis of racial and religious differences in order to ensure the “quality of American stock.” Even a cursory inspection of U.S. immigration case files since 1891 reveals how particular immigrant bodies have been racialized, scrutinized, checked for diseases at the border, and deemed inadmissible.
Public health measures like quarantine, surveillance, and behavior control have historically targeted people who are already disadvantaged, marginalized, especially immigrants, the poor, and people of color. For example, gays and lesbians were inadmissible to the U.S. for decades as they were deemed “afflicted with psychopathic personalities.” In the early 1990s, Haitian refugees who tested positive for HIV were imprisoned at the naval base at Guantanamo Bay. During the SARS epidemic in 2003, Chinatown in New York City was identified as a site of contagion even though it had no actual case of SARS. Conservatives are now blaming the recent arrival of Central American minor refugees for spreading diseases such as leprosy or tuberculosis, regardless of the fact that many of these children have developed illnesses as a result of their prolonged detention in unsanitary U.S. jails. With this disturbing history in mind, we must be extraordinarily vigilant about calls for visa and travel restrictions, especially those based on racialized public health threats, that so often serve as an attempt to scrutinize, stigmatize, and exclude brown and black bodies before they even come to the United States.
By and large, immigrants—even those from Ebola-affected countries—do not pose a significant health risk to the United States. (The U.S. has even survived an Ebola outbreak previously in Reston, VA). Existing law adequately screens and renders inadmissible anyone who is deemed “to have a communicable disease of public health significance.” Under current law, foreign nationals who wish to come to the United States generally must obtain a visa and submit to an inspection to be admitted. Intending immigrants must receive standard vaccinations against the following communicable diseases: mumps, measles, rubella, polio, tetanus and diphtheria toxoids, pertussis, influenza type B and hepatitis B. All things considered, intending immigrants to the United States are far better immunized than Americans, and more susceptible to catching diseases from Americans. And rest assured, Ebola is considered a communicable disease of public health significance, and passengers to the U.S. from Ebola-infected countries are screened for it.
However, unlike many diseases on the publicly communicable list, Ebola is actually not highly contagious. The virus is not transmitted through the air, and an average of 1-2 people are infected from each new Ebola patient (compared with measles, which infects an average of 18 people). As a world leader, the United States would send a distressingly bleak message to the rest of the world if it implements a travel ban based upon the latest outbreak of Ebola, instead of making a global commitment to combat this devastating disease. Others have written extensively about the public health reasons why a travel ban would be a bad idea, so there is no need to address them here.
Ebola has had a devastating impact on thousands of families and communities. Instead of spreading fear, our leaders must take a stand against racism and stigma and act out of empathy and humanity. Rather than enacting a travel ban founded on a racist history of exclusion, they must assemble the necessary public health resources to contain this epidemic in West Africa by building hospitals, sending medical teams, treating patients, isolating their contacts, making experimental drugs more widely available, and educating communities about how to protect themselves.
Lindsay Schubiner, M.A. in Public Health, Harvard, contributed to this article.