Farewell to the God of Plague: Chairman Mao’s Campaign to Deworm China, Stanford: University of California Press, 2016. 376 pp. isbn: 978-0-520-28883-6 (Hardcover)

Farewell to the God of Plague takes its title from Mao Zedong’s famous poem celebrating China’s campaign against schistosomiasis. Although historian Miriam Gross begins by attributing the campaign to Mao’s personal interest, his commitment to eradication may have had deleterious effects on long-term efforts at control of the endemic disease (102, 136). The real heroes of this story are those inspired by Mao—the “shit doctors,” taunted even by local children (189), and the young women who squatted to snatch up snails with chopsticks. Doing the dirty work, educated youth became “true grassroots activists who would faithfully promote alien Party campaigns and act as catalysts for rural change” especially during the allegedly antiscientific Cultural Revolution (182). Gross thereby upends many of our assumptions about the inverse relationship between science policy and political movements in Maoist China.

Previous scholars followed Communist debates to argue that the People’s Republic of China had to weigh its commitment to either ideological adherents or scientific experts. According to this interpretation, the government vacillated in its priorities, and the Reform era represented a return to technocracy after the Cultural Revolution. In contrast, Gross explains how political mobilization for the public health campaign functioned at different levels of government. In order to cut across weak horizontal lines of communication (relative to vertical ones), the government developed special channels for projects like the public health campaign against snail fever (47). Even so, snail fever stations generally enjoyed greater support among the Ministry of Health than local health departments (51). Rather than positing “red” against “expert,” Gross argues, “The Party was using grassroots scientifically oriented campaigns as a training ground to disseminate the tools that underpinned both science and rationalized bureaucracy” (203). The real issue was penetrating to the local level; the real zero-sum game was that of local resources and labor.

Gross first establishes obstacles and difficulties. The primary focus of impoverished rural communities was immediate agricultural output rather than long-term prevention (64). “Without any food, how can I produce shit [for samples]?” Gross reports one insolent villager as complaining (147). Farmers were busiest precisely in the seasons when snails were above ground and thus easiest to catch (129). Furthermore, farmers not only used excrement as fertilizer but also sometimes sold the family’s cache for cash in lean times (126). People waded into infested waters to fish in order to supplement their diets. The public health campaign thus disrupted basic survival tactics. Local cadres thus sometimes engaged in “economic sabotage” in order to “undercut the campaign” deliberately (65–66). Top-level government officials sometimes incentivized the campaign, by, for example, pairing prevention measures to eliminate snails from the ground with grants to expand irrigation works (132). Because snail elimination was so tedious, however, locals sometimes simply dumped the infected soil further afield, thus, ironically, further spreading the disease (129).

Public health regulations were not only laborious, but they were also extremely intrusive. Sampling work and photographic representation violated cultural norms of modesty (148, 164). Villagers were not accustomed to defecating on commodes, and the campaign thus upended basic daily practices. Like treatment, less intrusive measures were often more expensive and confined to urban areas (151). It was also hard to persuade asymptomatic victims that they needed intrusive medical treatment. The educated youth employed as medical professionals also did not look the part of authorities, and villagers and patients often found their instructions unwelcome.

Gross considers all sides of the campaign—what constitutes science and who performs science, as well as how measures were enacted. The campaign emphasized what Gross terms Mao’s “grassroots science” rather than normative science, and scientific popularization, sometimes at the expense of the authority of vaunted scientists (182, 204). Nevertheless, officials often failed to convey their message correctly (89, 98). Campaigns overly focused on equipment, such as microscopes, rather than teaching villagers how to interpret the images (94). Villagers rightly questioned why some snails were edible and others were diseased. Authorities also failed to explain the long dormant period of the disease, which would have justified painstaking prevention campaigns. Sometimes, visual aids even confirmed superstitious beliefs that the disease was caused by spirits (100). And yet, Gross shows that with sustained training, villagers could fully understand the disease and more successfully teach others (95). These were the political and cultural insiders necessary to undertake the work of the campaign.

Gross credits Mao both for initiating the campaign and for inspiring educated youth to carry out the taxing work of prevention and treatment. Although success rates varied along with the education level of the work teams (128), educated youth developed structural solutions (what Gross calls “scientific consolidation”) to provide regular statistical information (204). Likewise, treatment cards helped to prevent patients from slipping through the cracks (171). Such measures continued to provide reliable information flows that suggested better solutions (216). Thus, in the end, Gross reverses our usual identification of Maoism with political fervor, and instead places it in the context of the construction of a technocratic state.

Miriam Gross’s Farewell to the God of Plague explains a complex case study clearly and entertainingly. Upper-division undergraduates will find the book easily accessible. The book is not organized strictly chronologically, and instructors could select a chapter to fit into a course theme, whether popular science or local governance. It could best be paired with Sigrid Schmalzer’s Red Revolution, Green Revolution: Scientific Farming in Socialist China (Chicago: University of Chicago Press, 2016), because both authors show educated youth as both “red” and “expert,” especially in the sense of drawing upon local knowledge. With numerous comparisons to public health campaigns elsewhere throughout the book, and a sustained comparison in the conclusion, Farewell to the God of Plague should also serve as a good primer for public health professionals around the world, reminding them to pay heed to social conditions and local needs.