California’s first Chinese immigrants arrived at a tumultuous time. From the 1860s to the early 1900s, a raft of epidemics, from smallpox to cholera, ravaged the San Francisco Bay Area, and especially Chinatown. Lacking scientific research on disease transmission, local health officials often blamed outbreaks on living conditions in Chinatown and the vices of its inhabitants. In 1877, the surgeon Hugh Toland told a congressional committee that Chinese sex workers caused 90 percent of syphilis cases in the city.
This history makes the recent uptick in anti-Asian discrimination, associated with the COVID-19 pandemic, seem searingly familiar. In 1885, San Francisco’s health officer declared Chinatown a “social, moral, and political curse to the community.” The Board of Health proposed draconian measures to quarantine and destroy buildings where infections had spread, demolishing many businesses and homes in the process. Public officials not only portrayed Chinese Americans as breeders of disease, but also denied the group access to health care, refusing to finance critical services in Chinatown and raising the cost of treatment for Chinese patients at municipal hospitals. As a result, the Chinese accounted for less than 0.1 percent of hospital admissions in the late-19th century, according to medical records from city and county institutions.
In response, the Chinese diaspora organized. Well-connected merchants of the Chinese Six Companies—a federation of mutual aid associations—decided to self-fund their own hospital. In 1900, the year the bubonic plague hit San Francisco, Tung Wah Dispensary opened its doors to Chinatown residents, becoming the first Chinese-American medical facility in the continental U.S. A quarter-century later, it became the Chinese Hospital, which now has locations all over the Bay Area.
Laureen Hom, a political science professor at CalPoly Pomona, wrote a case study about the origins of the Dispensary. Atlas Obscura asked her about the long history of discrimination and civic engagement in Chinese enclaves, and how they resonate in the time of the new coronavirus.
With practically no clinics in San Francisco’s Chinatown, how did the Chinese get treated for cholera, tuberculosis, and other infectious diseases?
They relied on their own resources. Chinese immigrants from the same family lines or regions in China formed mutual aid associations, and provided the community resources the government denied. They maintained small, makeshift clinics for ailing members. People could also rely on folk healers who provided traditional medicine. These groups became the de-facto community governance in the face of exclusion.
How did the Chinese Six Companies get the funding and manpower to build Tung Wah Dispensary, which was later rebranded the Chinese Hospital?
When we learn about early Chinese history, we focus on working-class laborers. But there were also immigrants from the merchant class—what we would consider the elite. They became leaders of these associations and interacted with public officials to bring services to Chinatown. They were the middlemen. They also had transnational links with associations back in China, which was another way to pull in resources.