Yellow Fever and Other Plagues: Saint-Domingue, Biopolitics, and the Roots of Racism in American Public Health

Sam Millner //

“Let’s be realistic: the Atlantic is the Atlantic (with all its port cities) because it was once engendered by the copulation of Europe — that insatiable solar bull — with the Caribbean archipelago; the Atlantic is today the Atlantic (the navel of capitalism) because Europe, in its mercantilist laboratory, conceived the project of inseminating the Caribbean womb with the blood of Africa; the Atlantic is today the Atlantic (NATO, World Bank, New York Stock Exchange, European Economic Community, etc.) because it was the painfully delivered child of the Caribbean, whose vagina was stretched between continental clamps, between the encomienda of Indians and the slaveholding plantation, between the servitude of the coolie and the discrimination toward the criollo, between commercial monopoly and piracy, between the runaway slave settlement and the governor’s palace; all Europe pulling on the forceps to help at the birth of the Atlantic….”[1]

Antonio Benitez-Rojo, The Repeating Island

If Columbus’ crossing of the Atlantic set the stage for our late racial capitalist world order, it was the Caribbean — his point of first landfall in the “New World” — where this system was truly forged. In this cultural laboratory, European forces first engendered the structures that came to underpin global colonialism. Here, colonizers moved on from the native encomienda system to the transatlantic chattel trade: where the labor of expendable black bodies became a source of enrichment for the European metropole. The 1791 Haitian Revolution — the first successful Black anticolonial revolt — threatened this system and engendered further resentment and prejudice toward Black people. Anti-Black prejudice spilled over into North America during the 1793 yellow fever epidemic in Philadelphia. The city had received hundreds of refugees from Saint-Domingue, some accompanied by those they enslaved. When yellow fever struck, these enslaved Africans were immediately blamed for the outbreak. Later, pseudoscientific racial beliefs were used by white authorities to mold the local Black population into a medical proletariat to care for the city’s white population, and then later redirected to persecute Black caregivers.

These two cases highlight recurrent features of the Black encounter with American public health and security institutions: on the one hand, the social and material exclusion of Black communities and the constitution of the Black non-subject, on the other, high levels of biopolitical interference.[2] In explicitly colonial settings, Black people have been viewed as a subhuman and subject to exploitation and eradication, while in civil societies, where the process of a government reducing its citizens to a biological mass and implementing bodily regimentation is intended to promote a greater good (security, health), Black people have been excluded from that public. While in a state of exception, citizens are subjected to increased bodily regimentation for their own purported benefit, Black people are made into a first line of disposable human capital that can be sacrificed to save white society. [3] This anti-Black necropolitical logic found its way to American shores early on and became foundational to American public health systems even in “free” states.

Well before yellow fever returned to Philadelphia in 1793 after a thirty-year absence, the noxious scourge of scientific racism was entrenched in the socio-economic structures of the North American colonies. From the onset of colonial settlement, Western scientific thought viewed the Americas and especially the Caribbean as “putrid” and “unhealthy” for whites and turned to enslaved Africans to supply labor.[4] By the height of the eighteenth-century European sugar and coffee boom in the 1780s, Saint-Domingue was importing forty thousand enslaved West Africans each year. [5] In the context of increasing colonial economic demand, ideas about human diversity that circulated during the Enlightenment were projected onto the colonial context. These ideas included climatic determinism and the debate between monogenism and polygenism. This process produced an immutable conception of race (i.e. racial fixity) that served as an ex post facto justification for the system that necessitated its creation. On this conception, Black people possessed a unique, inherent nature that made them disposed to performing colonial labor. This lens of racial immutability influenced the medical views of the era, which misconstrued the acquired resistance of West African slaves to yellow fever as an inherent immunity that evidenced their unique suitability for strenuous agricultural labor in the tropics.[6] The widespread notion of racially differentiated immunity not only informed the need to continually import enslaved West Africans rather than relying on European or Native American labor but also conditioned views of Africans born in the New World who lacked environmental exposure, namely Philadelphia’s small African-American community. 

The colony of Saint-Domingue was remarkable for its massive, factory-like scale and sheer physical brutality. Amidst the backdrop of the Black encounter with European colonialism, Saint-Domingue constituted a unique historical situation, a laboratory of sorts that pushed the frontiers of emerging Western biopolitics and bodily regimentation. Saint-Domingue’s population consisted overwhelmingly of enslaved Africans, numbering five hundred thousand by the fall of the Bastille in 1789.[7] The remainder of Saint-Domingue’s society consisted of thirty-thousand mulattoes (gens de couleur) and forty thousand whites, who constituted a mixed bourgeoisie and a white upper class. By 1789, Saint-Domingue was the crown jewel of the French colonial empire, as well as Napoleon’s forward base to project power onto North America. While an acre of land on a Saint-Domingue plantation was believed to be more profitable than any land on earth, the colony was also reputed to contain unparalleled levels of human misery. Saint-Domingue’s network of eight-thousand plantations relied on a massive workforce of enslaved Africans to produce sugar, coffee, cotton, tobacco, indigo, and cacao, which were then shipped to the French ports of Marseille, Nantes, and Bordeaux to meet the ravenous European demand for New World commodities.

 But the crux of this wonder of the colonial world was always its plantations, which were exceptionally labor-intensive and required hundreds of enslaved people working in mechanical lockstep. Such conditions engendered a constant threat of subversion, which the French authorities controlled via the threat of brutal reprisal. Enslaved people were subjected to draconian punitive measures such as whipping, imprisonment, rape, and branding. In fact, it was considered more economical for plantation owners to work enslaved people to death and replace them than to provide them with the bare minimum of living standards.[8] Like other colonies during these years, Saint-Domingue was the site of social experimentation in the sense that punitive measures and bodily regimentation had not been implemented on such a large, industrial-scale and in such extreme measure.[9] But unlike other colonies, Saint-Domingue’s unique demographic situation made it stand out as factory-like: a paranoid, colonial patchwork society directing the entranced death dance of a large-scale automaton network ostensibly hardwired for its function. In contrast to American chattel slavery, which relied on reproduction to increase the workforce, this system was built upon the regular liquidation of a sizable portion of its enslaved population. A misanthropic radicalization of the politics of controlling life, it represented sovereignty in its severest form: the power to dictate who lives and who dies.[10] While Saint-Domingue’s untenable demographic equation would ultimately result in its downfall (after years of intermittent uprisings, a rebellion in 1791 began to pave the way for independence as the world’s first Black republic in 1803). The magical, racialist ideologies underpinning the colonial system nonetheless left an indelible mark on American social institutions. Saint-Domingue’s necropolitics was in many respects sublimated into more subtle forms in America’s industrial-scale, impersonalized health and criminal justice systems.

After the revolutionary French National Assembly published La Déclaration des droits de l’homme et du citoyen in August 1789, declaring all men free and equal, but not abolishing slavery in the colonies, Dominguan free men of color began to agitate for their right to vote.[11] As the centerpiece of the French colonial empire grew increasingly unstable, upper-class Dominguans began to flee the island for fear of having their wealth expropriated.[12]As early as 1790, Philadelphia and other American port cities were experiencing an influx of refugees from Saint-Domingue, mostly upper-class enslavers and those they enslaved. Their reception in America was mixed. On the one hand, Philadelphia’s white ruling class treated the transplanted white enslavers with compassion, raising almost $14,000 to assist their resettlement.[13] On the other, the enslaved Black people themselves (as well as the minority of free Blacks) were treated with suspicion and animosity. South Carolina, Georgia, and North Carolina passed a series of laws barring the entry of free Blacks from the West Indies and calling for the deportation of enslaved Black people who had previously migrated.[14] American whites feared Caribbean slaves as potential rebels and troublemakers who might try to incite revolt amongst the repressed local African-American communities.

In July 1793, two thousand refugees from Sainte-Domingue — mostly white, mulatto, and free black enslavers and their human chattel — landed in Philadelphia and settled together between Second and Fourth streets along Front and Walnut Streets. Shortly thereafter, several immigrant sailors involved with those ships succumbed to a fever at a boarding house on North Water Street. After a number of other patients succumbed to identical symptoms in early August, Benjamin Rush, a prominent Philadelphia physician and civic leader, declared that yellow fever had returned to Philadelphia. Its return was promptly blamed on the newly arrived Saint-Domingue refugees.[15] Deaths became so frequent that the College of Physicians asked city officials to stop the tolling of bells because the incessant ringing was producing panic. Rush called on all who could to flee the city, effectively causing a white flight to the countryside that left behind Philadelphia’s lower class, namely the city’s minority African-American community.[16], [17], [18]

While Black people, by virtue of their structural poverty, were excluded from the positive biopolitics of Rush’s evacuation order, they were subjected to other public health strategies. Based on the racialist assumption that Black people possessed an immutable, inborn immunity to yellow fever, Rush strongly urged the leadership of Philadelphia’s free Black community to enlist their fellow freedmen as frontline workers to take care of Philadelphia’s vulnerable white population. Absalom Jones and Richard Allen, the leaders of Philadelphia’s Free African Society, viewed this as an opportunity to improve the social standing of Philadelphia’s Black community vis-à-vis their white neighbors. Under their direction, the Black community undertook the grueling and degrading work of combatting the yellow fever pandemic, working as nurses, cart drivers, and gravediggers, in sharp contrast to the bucolic escape enjoyed by George Washington, Thomas Jefferson, and other members of the Federal Government.[19]

However, the Philadelphia Black community consisted mostly of American-born freedmen who had no environmentally acquired yellow fever immunity, unlike the imported enslaved people in Saint-Domingue. Rush’s scheme to utilize innate Black immunity was based on the pseudoscientific polygenist ideology that influenced colonial logic.[20] At the end of the epidemic in autumn 1793, Jones and Allen publicly cited a bill of mortality published by the clerks of Christ Church and St. Peter’s Church, which listed countless Black deaths and could “convince any reasonable man … that as many coloured people died in proportion to others.”[21] Rather than a demand for reparations, these comments actually arose as Jones and Allen attempted to defend their community from mounting conspiracy theories lobbed by white Philadelphians.

 In November, Matthew Carey, a prominent white printer, published an inflammatory pamphlet codifying these conspiracy theories. While also critical of Rush’s handling of the epidemic, he focused on Philadelphia’s Black community, claiming that “The great demand for nurses … was eagerly seized by some of the vilest of the blacks…. They extorted two, three, four or even five dollars a night for such attendance, as would have been well paid by a single dollar. Some of them were even detected in plundering the houses of the sick.”[22]  In response, Absalom and Jones released their own pamphlet highlighting the horrid conditions faced by Black nurses, who often worked up to ten days at a time, as well as the unequal treatment they faced compared with non-Black caregivers: “When the people of colour had the sickness and died, we were … told it was not with the prevailing sickness, until it became too notorious to be denied…. Thus were our services extorted at the peril of our lives.”[23] The swiftness with which white Philadelphians were willing to turn on their Black compatriots who had nursed them resembled the natural suspicions with which they treated Dominguan refugees. Despite Jones and Allen’s best intentions, they found themselves up against a racialized system of control that marked Black people as disposable and ancillary to the general good of white Philadelphians. Though more subtle than the sugar fields of Saint-Domingue, Philadelphia’s subliminal necropolitics still placed Black people at the bottom of a racial hierarchy. It is critical to recognize this disregard for Haitian and African-American life as coming from a long tradition of Western erasure of Black subjectivity. The early American exoticization of Haiti and the subsequent conflation of African Americans with Haitians are both strains of the white supremacist necropolitics: sovereignty that controls the life and death of its population, liquidating a subgroup to benefit a master subgroup. This is the logic of Leclerc’s genocidal campaign to reconquer Haiti as much as it is of the international community’s postcolonial campaigns to undermine Haitian sovereignty and decenter the subjectivity and human rights of its inhabitants.

Whether conscious or not, the overt racial violence incubated on Caribbean plantations has reproduced itself repeatedly as a white supremacist cultural logic that continues to orient American public health and security infrastructures. Much like a virus, it spreads and evolves, takings new forms, from the genocidal clockworks of Saint-Domingue to the absurdly cruel treatment of Philadelphia’s Black community in 1793. The necropolitical rationality of modern Western society rears its head during epidemics and other “states of exception” where the government flexes its power to coerce the extreme bodily compliance of its citizens. After the massive redistribution of the population during the colonial era, the same drive for racial expansion has turned inward in our multicultural, postcolonial democracies.[24] Upon reviewing the disproportionate suffering experienced by the African-American community during the COVID-19 pandemic, no doubt due to systemic disparities (healthcare access, housing conditions, etc.) and overt discrimination, it is clear that the death logic of the West marches on at full pace in the United States today.

Author: Sam Millner is a policy analyst at the Jewish Institute for National Security of America and serves as an ACCESS Leadership Fellow with the American Jewish Committee, where he works to promote Jewish-Muslim relations. Sam is a graduate of Columbia University, where he majored in International Relations with a concentration in French and Francophone Studies, winning the French Department Senior French Prize. Sam has worked on various Democratic campaigns and interned in the Washington, D.C. office of Congresswoman Debbie Wasserman-Schultz. While at Columbia, Sam consulted for a venture capital firm and later founded and sold off a tech start-up before serving as a Kimmel Fellow with the American Jewish Committee during his senior year.

Image Source: “Reverand Richard Allen and Reverand Absolom Jones,” The Mark E. Mitchell Collection of African American History. “Yellow Jack,” from Frank Leslie’s Illustrated Newspaper, September 21, 1883.


Benitez-Rojo, Antonio. The Repeating Island: The Caribbean and Postmodern Perspective. Durham, NC: Duke University Press, 1997.

Carey, Matthew. A Short Account of the Malignant Fever, Lately Prevalent in Philadelphia: with a Statement of the Proceedings That Took Place on the Subject in Different Parts of the United States. Philadelphia, PA: Matthew Carey, 1793.

CDC. “Health Equity Considerations and Racial and Ethnic Minority Groups.” Centers for Disease Control and Prevention. Last modified April 19, 2021. Accessed May 20, 2021.

Farmer, Paul. Infections and Inequalities: The Modern Plagues. Berkeley, CA: University of California Press, 1999.

Hanink, Elizabeth. “Black Nurses and the 1793 Philadelphia Yellow Fever Epidemic.” Working Nurse. Accessed November 30, 2020.

Historical Society of Pennsylvania. “Richard Allen: Apostle of Freedom: The Free African Society.” Historical Society of Pennsylvania. Accessed November 30, 2020.

James, C.L.R. The Black Jacobins: Toussaint L’Ouverture and the San Domingo Revolution. London, UK: Secker & Warburg, 1938.

Jennings, Eric T. “Acclimatization, Climatology, and the Possibility of Empire.” In Curing the Colonizers: Hydrotherapy, Climatology, and French Colonial Spas, 8-39. Durham, NC: Duke University Press, 2006.

Jones, Absalom, and Richard Allen. Narrative of the Proceedings of the Black People, During the Late Awful Calamity in Philadelphia, in the Year 1793: and a Refutation of Some Censures, Thrown upon Them in Some Late Publications. Philadelphia, PA: Franklin’s Head, 1794. ..

L’Assemblée nationale. “Déclaration des Droits de l’Homme et du Citoyen de 1789.” Légifrance. Accessed December 9, 2020.

Langley, Lester. The Americas in the Age of Revolution, 1750 – 1850. New Haven, CT: Yale University Press, 1996.

Mbembé, Achille. Necropolitics: Theory in Forms. Durham, NC: Duke University Press, 2019.

PBS. “Africans in America: A Narrative of the Proceedings of the Black People 1794.” PBS. Accessed November 20, 2020.

———. “Africans in America: A Short Account of the Malignant Fever 1793.” PBS. Accessed November 20, 2020.

———. “Africans in America: French West Indian refugees in Philadelphia 1792 – 1800.” PBS. Accessed November 20, 2020.

———. “Africans in America: Mortality.” PBS. Accessed November 20, 2020.

———. “Africans in America: The Yellow Fever epidemic 1793.” PBS. Accessed November 20, 2020.

Smith, Billy G. Ship of Death: A Voyage That Changed the Atlantic World. New Haven, CT: Yale University Press, 2013.

Smith, Mark A. “Andrew Brown’s ‘Earnest Endeavor’: The Federal Gazette’s Role in Philadelphia’s Yellow Fever Epidemic of 1793.” The Pennsylvania Magazine of History and Biography, October 1996.

Snowden, Frank M. Epidemics and Society: From the Black Death to the Present. New Haven, CT: Yale University Press, 2019.

[1]  Antonio Benitez-Rojo, The Repeating Island: The Caribbean and Postmodern Perspective (Durham, NC: Duke University Press, 1997), 5.

[2] Achille Mbembé, Necropolitics: Theory in Forms (Durham, NC: Duke University Press, 2019), 92,

[3] This racial calculus, deciding who will live or die based on color lines, is a typical example of Achille Mbembé’s “necropolitics.”

[4] Eric T. Jennings, “Acclimatization, Climatology, and the Possibility of Empire,” in Curing the Colonizers: Hydrotherapy, Climatology, and French Colonial Spas (Durham, NC: Duke University Press, 2006), 8, PDF.

[5] Frank M. Snowden, Epidemics and Society: From the Black Death to the Present (New Haven, CT: Yale University Press, 2019), 116, 113.

[6] Snowden, Epidemics and Society: From the Black Death to the Present, 115. Snowden notes that many African slaves acquired this resistance from contracting yellow fever in their childhood, while others enjoyed crossover resistance from having previously contracted dengue fever. Needless to say, this was not an inherent condition, thus the continued need to keep importing new slaves from West Africa.

[7] In comparison, Snowden notes that there were seven hundred thousand slaves throughout the United States at this time.

[8] Snowden, Epidemics and Society: From the Black Death to the Present, 117, 113, 118, 114.

Ibid., 117.

[9] Mbembé writes in Necropolitics how this radicalization of repressive and punitive measures was escalated even further during World War II by the Third Reich and the Vichy regime, noting that such excessive acts of mass death find their roots in German colonial practice in the African Southwest, 125.

[10] Mbembé, Necropolitics: Theory in Forms, 66.

[11] L’Assemblée nationale, “Déclaration des Droits de l’Homme et du Citoyen de 1789,” Légifrance, accessed December 9, 2020,

[12]  Lester Langley, The Americas in the Age of Revolution, 1750 – 1850 (New Haven, CT: Yale University Press, 1996), 110.

[13] It should be noted that these funds were diverted from pledges to a building fund for the local African Church.

[14] Pennsylvania followed suit in 1795 with its own series of prohibitions on the entry of French slaveholders into the state.

[15] Modern scholarship now points to a British merchant ship coming from the Caribbean, Hankey, as the principal vector. Billy G. Smith, Ship of Death: A Voyage That Changed the Atlantic World (New Haven, CT: Yale University Press, 2013).

[16] Mark A. Smith, “Andrew Brown’s ‘Earnest Endeavor’: The Federal Gazette’s Role in Philadelphia’s Yellow Fever Epidemic of 1793,” The Pennsylvania Magazine of History and Biography, October 1996, 326,

[17] PBS, “Africans in America: French West Indian refugees in Philadelphia 1792 – 1800,” PBS, accessed November 20, 2020,

[18] Elizabeth Hanink, “Black Nurses and the 1793 Philadelphia Yellow Fever Epidemic,” Working Nurse, accessed November 30, 2020,

[19]  PBS, “Africans in America: The Yellow Fever epidemic 1793,” PBS, accessed November 20, 2020,

[20] Hanink, ” Black Nurses and the 1793 Philadelphia Yellow Fever Epidemic,” Working Nurse.

[21] PBS, “Africans in America: Mortality,” PBS, accessed November 20, 2020,

[22] Matthew Carey, A Short Account of the Malignant Fever, Lately Prevalent in Philadelphia: with a Statement of the Proceedings That Took Place on the Subject in Different Parts of the United States (Philadelphia, PA: Matthew Carey, 1793), 77, PDF.

[23] Absalom Jones and Richard Allen, Narrative of the Proceedings of the Black People, During the Late Awful Calamity in Philadelphia, in the Year 1793: and a Refutation of Some Censures, Thrown upon Them in Some Late Publications (Philadelphia, PA: Franklin’s Head, 1794), 15, PDF.

[24] That is not to discount the postcolonial dynamics of the international political economy, which continue to drain the Global South to enrich the Western World.

Editor’s Note: This essay is part of a collection that grew out of a course on illness and francophone literature, culture, and history at Columbia University. Each essay speaks to the range of epidemics and medical encounters in France and the French empire that the course covered — from the plague outbreak in Marseille in 1720, to recent outbreaks of Ebola in West Africa, to the class’s own context of COVID-19. Offering new perspectives on these topics, the essays demonstrate how a pedagogical focus on illness can engage students in thinking about how literature might spark ethical and political reflection, and about how colonialism and race function as driving forces of history.

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