The Politics of Disease Control. Mari K. Webel

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СКАЧАТЬ claims on political authorities. For some communities, such as those forced to abandon homes and farms and move into “fly free” areas in Uganda, sleeping sickness arguably caused a significant rupture in everyday life and livelihood; the Ssese Islands archipelago, one of my case studies and part of the Buganda kingdom, was effectively depopulated for most of the first half of the twentieth century.³¹ In other areas, mortality catalyzed deep and durable change. But focusing only on the singularity of the disaster of epidemic sleeping sickness erases the intellectual, therapeutic, and political work that many people put into living through it. Focusing instead on that work illuminates durable continuities across the nineteenth and twentieth centuries.

      The particular interlacustrine cultural context of this book is crucial to understanding the variety of intellectual and practical resources available to affected populations by the late nineteenth century. My research on the responses and efforts of affected communities at the center of this book builds on robust studies of the social and political development of interlacustrine societies ranging over the past millennium.³² Studies of developments in deep historical time provide the basis for my engagement with linguistic and intellectual innovations amid epidemic illness, as well as my approach to long-standing political, social, and therapeutic resources oriented around clans, healing societies, and spirit mediumship.³³ These earlier histories of interlacustrine politics and society are also in dialogue with analyses of political legitimacy, health, and prosperity as conditions changed with the advent of colonial incursion in eastern-central Africa in the nineteenth century. Foundational work on the relationship between political legitimacy and health—understood in terms of fertility, prosperity, and/or the absence of serious illness, among others—provides a key register within which I analyze reactions to epidemic illness on the Ssese Islands and in Kiziba.³⁴ Scholarship on eastern-central African societies has encouraged me to be particularly attentive to the politics and meanings of specific places and kinds of spaces, as well as people’s movements within them.

      This book brings the insights of studies of health, politics, and healing into dialogue with studies of the technologies and tactics of colonial disease prevention. I focus on the emplacement, development, and ongoing work of colonial sleeping sickness camps and the situated intellectual, therapeutic, and political worlds of the people that the camps targeted. Here, my approach to the early colonial era in the Great Lakes region is also guided by studies of late colonial and post-colonial health and illness. These accounts view efforts to define disease, healing and medical practices, and treatment-seeking as both embedded within and evidence of broader changes. This scholarship has shown that individuals and communities navigated illness or misfortune in creative, generative ways and tried to achieve health and prosperity amid a rapidly changing world through evolving and complex practices.³⁵ The histories I offer here restore a sense of the messy, negotiated, and deeply contingent nature of early sleeping sickness research and prevention efforts; they underscore how profoundly these efforts were shaped by local experiences. This is especially important when, in time, anti–sleeping sickness campaigns have come to be understood as rigid and draconian manifestations of colonial power, and, further, when medical and scientific literature continues to either obliquely or directly credit colonial campaigns as effectively reducing sleeping sickness mortality.³⁶

      My work builds on scholarship that established clear connections between the political, social, and ecological disruptions of colonial incursion and the spread of trypanosomiasis (among other maladies), and that has shown how sleeping sickness was intimately linked with new, extractive economic processes such as mining or rubber collection.³⁷ Histories of sleeping sickness that explore these connections generally keep within the confines of the nation-state and its colonial predecessor, emphasizing the singular approaches of the different European imperial powers and colonial administrations to controlling and preventing sleeping sickness.³⁸ Some have focused on the experiences of a specific region; others have addressed entire colonial programs to understand their implications for later national histories.³⁹ While histories of research emphasize the transnational and intercolonial nature of past scientific and medical efforts, and Africanist studies of labor and migration have long traversed colonialnational boundaries, this book is the first study to consider sleeping sickness prevention and control within a transnational and intercolonial frame.⁴⁰

      The particular circumstances of Lake Victoria and Lake Tanganyika, where multiple colonial states divided the lakes’ shores and engaged directly with one another around the problem sleeping sickness posed, encourages this approach. But the lived experiences of littoral populations, where mobility around the lake and connection with other societies were central, make it an intellectual necessity.⁴¹ Reflecting shifts in historical scholarship toward transnational and comparative methodologies, and, equally importantly, recognizing that the lives and experiences of Africans and Europeans alike were shaped by the vigorous mobility of people, goods, diseases, and ideas around the lakes, this book frames the problem of sleeping sickness within the ecologies and landscapes around Lake Victoria and Lake Tanganyika. This reframing of sleeping sickness not simply as a Ugandan, Tanzanian, or Burundian concern foregrounds the connections between populations that preceded partition and endured despite the advent of the colonial state. Considering the phenomena of sleeping sickness mortality, prevention, and control within an interlacustrine world—a world defined by historic states and tributary kingdoms, complex economies of land and labor, and the lakeshores’ ecosystems—rather than in colonial-national units allows me to focus on the vitality of African mobility and interchange. This interlacustrine and intercolonial frame also allows me to pay particular attention to polities and societies for which colonial borders were a new imposition and one with varying significance for daily life. By virtue of their location at or near colonial borderlands, these populations had distinctive experiences of mobility and sleeping sickness. They were marginal to the centers of power in the region: distant from commercial and political hubs of the Indian Ocean coast and peripheral to the capitals of interlacustrine kingdoms. But they held an important place in colonial prevention and control campaigns and were central to managing the spread of disease in a new era of public health surveillance. Often, sleeping sickness research, surveillance, and prevention were African populations’ earliest and most consistent engagement with Europeans or the colonial state, and the book’s interlacustrine and intercolonial framing illuminates similarities and divergences in their experiences.

      I also approach my three areas of focus—the Ssese Islands, the kingdom of Kiziba, and the Imbo lowlands—with time in mind, concentrating on a particular moment when sleeping sickness had a high impact for colonial and African authorities alike. The early 1900s were a moment of uncertainty: neither African authorities nor healers nor European scientists nor colonial bureaucrats had a firm grip on where the sleeping sickness epidemic came from, how precisely it spread, or what measures should be taken to control it. This productive uncertainty shows how simultaneous intellectual, political, and practical efforts of European and African actors mingled and conflicted in generative ways.⁴² I show that accretions of new information and processes of scientific change in tropical medicine and public health more broadly did not occur solely based on Europeans’ intellectual orientations and experiences—the “eureka!” moments of white researchers in a remote, humid laboratory or a dusty field site. Rather, new ideas and strategies that manifested in colonial sleeping sickness policies—such as the atoxyl-focused sleeping sickness camp—had their origins in interactions with and adaptations to the political, social, and environmental dynamics of Ssese islanders, Ziba royal authorities and their subjects, or Bwari and Rundi people in Imbo. Researchers, doctors, and colonial public health officials immersed in sleeping sickness work also absorbed elements of the intellectual worlds, morality, and political ideologies of their African interlocutors, even if these Europeans at the time saw those African people primarily as patients to dose, bodies to study, or people to target.

      Sleeping sickness proves a particularly apt tool for prying open the discrete eras of modern African history—divided by colonial rule, the world wars, or political independence—to facilitate considerations of historical continuity in public health.⁴³ This stems from the persistence of sleeping sickness as a health concern in rural Africa and relates to the СКАЧАТЬ