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The cultural economy of public health in British West Africa, c.1865–1965

July 22, 2010

By Ryan Johnson

Hospital in Bathurst, Gambia, c.1911.

The primary aim of my project is to understand the interplay and impact of culture and economics on the language and practical outcomes of public health policy in British West Africa, c.1865–1965. It also attempts to place British West Africa within a global context.

While I will primarily investigate the successes and failures of public health policy in British West Africa, I will interpret them in relation to the rise of global uniformity and interconnectedness during this period. An analysis of public health policy is ideal in this respect because it speaks not only to larger global economic and political changes but also to the more difficult realms of culture, ideology and bodily practices. Overall, by drawing the local and the global together, this project will hopefully shed light on the changing nature of Britain’s world system, and its evolving ambitions throughout the period under study, enriching not only the history of medicine and imperial and colonial history, but world history as well.

Head of a guild of herbalists, Nigeria, 1937.

Integrated analysis of policy making and the importance of economic factors in colonial contexts is by no means exceptional, but it has become increasingly rare, the tendency being to eschew the more problematic areas of implementation and ‘response’ and to concentrate on rhetoric and cultures of colonialism. My project hopes to remedy this by placing both culture and economics in the same analytical framework. One particularly novel feature will be the attention given to commercial factors, which appear to have played a disproportionately important part in the development of colonial health policy in this region. When investigating the formation of public health policy in West Africa, historians have typically focused on polices of ‘constructive imperialism’ emanating from Joseph Chamberlain and the Unionists. The City, however, is traditionally distanced from interests in West Africa. An exciting facet of the project is to question this assumption by investigating the intricate economic and cultural networks that linked the City with the majority of traders and merchants holding interests in West Africa.

Another important aspect of the research is looking at the role of local men and women. West Africans had long been in contact with Europeans and Western medicine. Therefore, it is likely that they had a significant impact on the formation and execution of public health policy. The research will attempt to identify the ways in which West Africans were capable of influencing and shaping public health policy and practice in the region. One place to begin answering this question is investigating the many talented Western-trained West African physicians practising throughout the 19th and 20th centuries. A powerful West African elite, a class to which these physicians often belonged, also wielded significant influence in the region. Finally, the project will investigate the work of West African intermediaries and medical subordinates. This includes the work of vaccinators and dispensers trained by the colonial state, as well as that of healers and herbalists, who were an integral component within the network of healthcare providers in West Africa.

Overall, my proposed research is concerned with understanding problems affecting modern-day policies and programmes of public health in West Africa and the rest of the global South. How might current problems of healthcare implementation and delivery be rooted in the colonial past? And how can a study of public health in British West Africa help us to ameliorate these problems?

Dr Ryan Johnson is a lecturer in History at the University of Strathclyde.

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