Compulsion, Localism, and Pragmatism: The Micro-Politics of Tuberculosis Screening in the United Kingdom, 1950–1965

(Re)locating the border: Pre-entry tuberculosis (TB) screening of migrants to the UK

“…At the international airport, moreover, health screening technologies -such as thermal image scanning -have increasingly been deployed (Welshman 2006;Budd et al, 2011). The effectiveness of these responses, often motivated by political imperatives, such as the desire of national governments to be 'visible' (Barker, 2012), have been questioned by clinicians (Abubakar, 2009;Cowling et al, 2010;Priest et al, 2011).…”

“…Tuberculosis has been marked by powerful associations since colonial times, and has frequently been cast as a disease of migration (Kraut, 1995;Bashford, 2002;King, 2003;Coker and Ingram, 2006;Welshman, 2006). Its resurgence in many European and North American countries since the 1980s -and clear differences in TB morbidity rates 'according to race, ethnicity and place of birth' (King, 2003: 40) -has, according to King, led to 'renewed concern over the borders that separate people ' (2003: 40).…”

“…Access to sovereign territory requires negotiation and the extent to which the governance of extra-territorial health interventions can reach across borders may be influenced by economic and geopolitical factors (Allen, 2003(Allen, , 2011Ingram, 2010aIngram, , 2010b. For example, there remained concerns within the UK government -similar to those expressed by officials during the 1950s and 1960s (Welshman, 2006) -that measures to introduce pre-entry screening to India may damage trading relations with a strategically important nation (NPO,personal communication,15/11/12). Moreover, medical professionals have been alert to difficulties in gaining access to specific countries, for example, China, Malaysia and Indonesia (NPO, personal communication, 15/11/12; UNHCR, 2012).…”

“…Nevertheless, the cross-border transmission of TB, a disease which many health professionals working in the middle part of the twentieth century believed could be eradicated, has been less widely researched. Although a longstanding topic of scholarly investigation by historians and social scientists (Farmer, 1997;Gandy and Zumla, 2002;Bell et al, 2006;Welshman, 2006;Welshman and Bashford, 2006), there has been little attention paid to the changing geographies of the detection and management of TB at (and beyond) the border. This is surprising given its increased prevalence in countries of the global North during recent decades, and its representation in the popular imagination as a disease associated with 'immigration' (Bell et al, 2006: 584).…”

The politics of securing borders and the identities of disease

“…Once established, however, disease identities are not inscribed automatically on the policies of nations. As Welshman (2006) demonstrates in the case of TB in Britain in the 1950s and 1960s, devising a screening strategy was a complex process and many factors – moral panics, a perceived demand for labour, the view of professional bodies – were involved in it. This leads to my second question: how do disease identities come to inform what countries do about screening immigrants?…”