There is a stranger in the hospital compound - his pockets brimming with money; his clothes brighter than the sunset and with smooth words of fame and fortune.
This electronic version has been made available under a Creative Commons (BY-NC-ND) open access license. The Colonial Medical Service was the personnel section of the Colonial Service, employing the doctors who tended to the health of both the colonial staff and the local populations of the British Empire. Although the Service represented the pinnacle of an elite government agency, its reach in practice stretched far beyond the state, with the members of the African service collaborating, formally and informally, with a range of other non-governmental groups. This collection of essays on the Colonial Medical Service of Africa illustrates the diversity and active collaborations to be found in the untidy reality of government medical provision. The authors present important case studies covering former British colonial dependencies in Africa, including Kenya, Malawi, Nigeria, Tanzania, Uganda and Zanzibar. They reveal many new insights into the enactments of colonial policy and the ways in which colonial doctors negotiated the day-to-day reality during the height of imperial rule in Africa. The book provides essential reading for scholars and students of colonial history, medical history and colonial administration.
John Iliffe's 1998 book is a history of the African medical profession in Uganda, Kenya and Tanzania from the earliest training of modern medical staff in the 1870s to the present day. Based on extensive research, and dealing exclusively with African doctors, it offers an understanding of professionalisation in the Third World. It describes the recruitment and education of doctors, their understanding and practice of modern medicine, the struggle for international recognition of their qualifications and efforts to develop East African medical systems after independence, and their experiences during a period of political and economic difficulty. The book ends with an account of the significant work of East African doctors in the study and control of AIDS. This is a major contribution to the social history of Africa and to the social history of medicine more broadly.
This is a lively and original book, which treats Western biomedical discourse about illness in Africa as a cultural system that constructed "the African" out of widely varying, and sometimes improbable, materials. Referring mainly to British dependencies in East and Central Africa in the late nineteenth to the mid-twentieth century, it draws on diverse sources ranging from court records and medical journals to fund-raising posters and "jungle doctor" cartoons. Curing Their Ills brings refreshing concreteness and dynamism to the discussion of European attitudes toward their others, as it traces the shifts and variations in medical discourse on African illness. Among the topics the book covers are the differences between missionary medicine, which emphasized individual responsibility for sin and disease, and secular medicine, which tended toward an ethnic model of collective pathology; leprosy and the construction of the social role of "the leper"; and the struggle to define insanity in a context of great ignorance about what the "normal African" was like and a determination to crush indigenous beliefs about bewitchment. The underlying assumption of this discourse was that disease was produced by the disintegration and degeneration of "tribal" cultures, which was seen to be occurring in the process of individualization and modernization. This was a cultural rather than a materialist model, the argument being that Africans were made sick not by the material changes to their lives and environment, but by their cultural "maladaptation" to modern life. The "scientific" discourse about the biological inferiority of "the African," traced by one school of scientists to defects in the frontal lobe, makes painful reading today; it persisted into the 1950s.
The role of the Colonial Medical Service - the organisation responsible for healthcare in British overseas territories - goes to the heart of the British Colonial project. Practising Colonial Medicine is a unique study based on original sources and research into the work of doctors who served in East Africa. It shows the formulation of a distinct colonial identity based on factors of race, class, background, training and Colonial Service traditions, buttressed by professional skills and practice. Recruitment to the Medical Service bound its members to the Colonial Service ethos exemplified by the principles of the legendary Sir Ralph Furse, head of Colonial Office recruitment to the Service. Thus the Service was to be a corps d'élite consisting of Furse's 'good men' - self-reliant, practical, conscientious, professionally qualified people whose personalities were 'such as to command the respect and trust of the native inhabitants of the colony'. Professsional qualifications were important but 'secondary to character'. Anna Crozier analyses all aspects of recruitment, qualifications, training as well as the vital personal factors that shaped the Service's character - religion, a sense of adventure, professional interest, ideas of imperial service, family traditions, professional ties, perceptions of service to humanity and the building up of a common service mentality among colonial medical staff. This is the first comprehensive history of the Colonial Medical Service and makes an important contribution to our understanding of the social and cultural aspects of medical history.