Suggested Readings

Mosquitoes that transmit chikungunya can be found throughout Réunion, so the entire island theoretically should have been exposed during the outbreak. However, not everyone was infected. According to Michel Setbon and Jocelyn Raude, people living in homes with gardens were at a significantly increased risk of contamination. Karine Aasgaard Jansen investigated this further and recognized the role that Réunionese households and their gardens (Jardin) play as a human-environment interface in the context of chikungunya. A Jardin simultaneously serves as a platform for social interaction, a sign of status, and a hub for everyday household tasks. A typical Jardin may contain anywhere from a few to several hundred potted plants– the saucers of these pots accumulate stagnant water and serve as artificial reservoirs for mosquito breeding.

Public health interventions were primarily directed at the eradication of such mosquito breeding grounds via ‘demosquitofications’ conducted by French metropolitan soldiers, who disregarded the cultural-spatial boundaries of Jardin, leading to friction and refusal of demosquitofications. These demosquitofications also resurfaced historical associations of sanitation with disease and the accompanying stigma. One informant believed that if a Jardin was well-kept and clean, there could be no mosquitoes to transmit disease.

Jansen expands on the alternative etiologies reported by Réunionese and illustrates the complexity of their formations. The most common was miasma theory, or the idea that chikungunya is transmitted through ‘bad air’ and a contaminated atmosphere. Other etiologies originated from the Indian Ocean’s history of sea trade and the idea of disease as a transient matter of exchange that will pass. Jansen notes that the abundance of etiologies empowered patients to choose among illness narratives and potentially destigmatize infection, but played a detrimental role in control measures. If people did not believe mosquitos were vectors, they would not be willing to participate in preventative efforts.

Perceptions of risk presented another challenge to public health efforts. Setbon and Raude noted that if people were not particularly worried about the risk of contracting chikungunya, they would then be unwilling to adopt protective behaviors. Philip Weinstein and Srilata Ravi point to the failures of public health officials in France. By presenting chikungunya as a distant tropical disease affecting lesser peoples provided a rationale for France to maintain superiority and public health inaction during the epidemic. This perspective was furthered by print media representations of chikungunya in both Réunionese and French newspapers — the former presenting chikungunya as a mild disease well under control, the latter failing to acknowledge the epidemic until nearly a year after the first cases. This rhetoric reinforced the idea of a centered tropicality and France’s perception of Réunion as a negative ‘other.’ The misinformation presented to Réunion early on contributed to the widespread lack of perceived risk and consequent resistance to control measures. Only when the virus was perceived as a threat to France did the messaging change with calls for public health action.

Taken together, these five articles describe a devastating epidemic that could have been prevented had it not been hindered by public health inaction, tropicality, and colonial discourse.