COLONIAL MEDICINE ILLS
VERN BEAMISH

Colonialism and medicine may seem to be separate subjects on their own, but this
paper demonstrates how both subjects have interacted together in the recent
modern era and produced harmful effects on diverse populations. This article
reviews five sources that focus on different regions of the world. A common theme
emerges from the colonial application of medicine and from the power imbalance
that exploited the use of cheap labour. The combination of frenzied economically
driven colonization, and the rise of modern medicine imposed European social
constructs on Indigenous peoples, which caused them direct harm, and often
fostered the spread of disease. Under a false concept of racial differences and
implied hierarchy, European countries frequently failed their colonial subjects.

In the late 19th and early 20th centuries, European countries were at the vanguard of
new technological advances in medicine. These modern advances helped
strengthen national identities and allowed unprecedented economic expansion to
faraway tropical lands. Competitive European imperialism is entangled with the
rise of modern medicine. Alfred Reed, Chair of Tropical Medicine at the University
of California, maintained that institutes like his own were the “advance agents of
commerce.” 1 The combination of frenzied economically driven colonization, and
the rise of modern medicine imposed European social constructs on Indigenous
peoples, which caused them direct harm, and often fostered the spread of disease.
Under a false concept of racial differences and implied hierarchy, European
countries frequently failed their colonial subjects. The journey of colonial medicine
can be seen by the transition from Western self-preservation, to the growth of
infrastructure that administered colonial subjects. The displacement of local
populations due to economic activity furthered the spread of disease and forced the
locals to live in unhealthy conditions. The reliance on the exchange of cheap labour
Alfred Reed, “Organized tropical medicine in the Western United States, California and Western
Medicine 35 (1931): 185-9, quoted in John Farley, Bilharzia: A History of Imperial Tropical
Medicine (New York: Cambridge University Press, 1991), 130.

1

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for profit by remote Western institutes was so far-reaching that even traditional
domestic roles were colonized.
Colonialism and medicine are both comprehensive topics on their own, and the
intent here is to show how both subjects have interacted together in the recent
modern era and produced harmful effects on diverse populations. By restricting the
number of sources to a narrow range of five articles that focus on different regions
in the world, a theme emerges on the commonality of colonial medicine. Whether
the location is the Texas border with Mexico, Australia, Egypt, India, or Latin
America, local populations endured similar negative consequences from the power
imbalance inherent in colonial settings.
In the present day it seems obvious to reflect that the colonial age was the cause of
much suffering, but it may not seem apparent that medicine would be complicit
with this suffering. After all, it is generally recognized that humanity has benefitted
from modern medicine. However, colonization is a multi-faceted process, and it
influenced the application of medicine right from the beginning. As Europeans
ventured farther away from home, there was great concern for the rising mortality
rates among military personnel, travellers, and colonists as they came into contact
with different people and environments. Additionally, in these expeditions
“European physicians, travellers and missionaries offered their medicine as
lifesaving drugs or as tokens of their benevolence and superiority to the colonized
races.” 2
Lifesaving drugs were typically prescribed for the protection of white people when
colonizing a foreign land, especially when tropical lands were the scene of white
struggles. Initially, miasmic theories (the outdated belief that disease was caused
by breathing in “bad air”) were prevalent, along with the perception that the soil of
the land was the source of disease. 3 An example of this occurred when the British
colonized Australia and struggled to cope with the severe climate in the northern
tropical area. Malaria was referred to as “Colonial Fever,” and the use of “quinine
generally seemed to act on white constitution to counter environmental influence.” 4
However, this did not solve the problem, and whites felt they needed the assistance
of non-local “tropical” residents whom they saw as more suitable to working the
land. This ultimately morphed into the belief that these “other people” were disease
carriers, promoting the cruel medical use of quarantine through isolation, with the
expectation that disease transmission to Europeans would be prevented.

Pratik Chakrabarti, Medicine and Empire 1600-1960 (New York: Palgrave Macmillan, 2014), ix.
Warwick Anderson, The Cultivation of Whiteness: Science, Health, and Racial Destiny in
Australia (New York: Basic Books, 2003), 181.
4
Ibid, 80.
2
3

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The evolution of medicine from protecting settler’s health to treating Indigenous
peoples, can be seen in the development of hospitals in the colonies. John Farley
notes that “before the First World War, tropical medicine was focused mainly on
the health of British Colonial officials and American army personnel. But after the
war, economic factors began to play an increasingly important role.” 5 Hospitals
were integral to improving profit because they were a way to keep cheap local
labour free from disease. From a colonial point of view, hospitals were “there for
purposes of development, not exploitation.” 6 However, to colonial subjects,
hospitals could be feared, as was the case in India where British officials were so
culturally insensitive with their campaign against the plague that “people would
prefer to die from the plague rather than consent or submit to the removal of their
mothers, wives, daughters or sisters to the hospital.” 7
“Tropical Medicine” became a professional specialty, with governments,
businesses, and educational institutes investing in research-driven initiatives. In
South Africa, funding research took place over “seriously addressing the health
problems of [mining] employees…[which could have been improved] by decent
housing, good food, and humane policies.” 8 It is cruelly ironic that the economic
activities in colonial lands forced local people to work farther from their own
homes, which in turn helped foster the spread of disease. The growth of colonial
economies was frequently tied to the use of cheap labour. These workers would
have to travel away from home and become dependent on their colonial masters for
basic necessities. In Australia, colonial officials perceived Pacific Islanders as
racially suited to tropical work, and “poor food, inadequate housing and medical
neglect meant the Islanders…had a death rate four times higher than that of
Europeans.” 9
With hindsight, it can be generally said that many disease outbreaks were caused
by the unsanitary conditions that poor people were forced to live in. Although not
a colonial takeover, the exploitation of migrant Mexican workers who travelled
daily to work in Texas is a classic case of racial hierarchy and the short-sighted
refusal to take proper steps to minimize the spread of disease. The border cities of
El Paso in Texas and Ciudad Juarez enjoyed an open border for many years as
Mexicans desperately sought work in part because of the Mexican Revolution, and
Americans eagerly welcomed these workers for the most undesirable work. 10
John Farley, Bilharzia: A History of Imperial Tropical Medicine (New York: Cambridge
University Press, 1991), 116.
6
Ibid, 117.
7
David Arnold, “Plague: Assault on the Body.” In Colonizing the Body: State Medicine and
Epidemic Disease in Nineteenth-Century India, (Berkeley: University of California Press, 1993),
214.
8
Farley, 124.
9
Anderson, 84.
10
Ibid, 121-22.
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Racial themes were prevalent including the statement that “the Mexican was
considered the perfect stoop laborer because he [had the right body type].” 11
This U.S and Mexico labour exchange became threatened when incidents of typhus
drove the U.S authorities to instigate harsh measures at border crossings to prevent
the disease from spreading. The death of twenty-six Mexicans in a Texas jail, due
to a delousing method using a gasoline mixture as a bath, illustrated the inhumanity
of quarantine methods. 12 Most of the Mexicans lived in impoverished settings, and
the lack of proper sanitation was the catalyst for the rise and spread of typhus. The
American solution of imposing border-crossing conditions ignored the fact that, if
they wanted to enjoy the benefits of cheap labour, it would have made more sense
to improve Mexican workers living conditions. They did not do so, and one of the
consequences was the “subsequent rise of illegal immigrants, some of whom
harbored infections or feared medical examinations of any kind.” 13 Although
Howard Markel was writing in 2004, it is striking that the hard border concept of a
wall still resonates with labour dependence issues and racial concepts by the U.S.A.
The colonial impulse to avoid direct aid to the oversupply of cheap labour is a
common theme throughout the world. In South Africa, medical experts knew that
the rise of Bilharzia corresponded with colonial irrigation projects. 14 However,
unhealthy workers could easily be replaced, and as a result, there was no incentive
to improve working conditions. In contrast, when similar impoverished living
conditions of white Boer farmers sparked a Bilharzia outbreak, “the response was
immediate when white children were found to be infected.” 15 Authorities instigated
a quarantine-like summer camp program for the white children that involved
medications and education. However, no similar effort was made for Black children
and “South Africans were unwilling to spend money to treat Africans infected by
Bilharzia [and] they were certainly not prepared to attack the economic factors that
increased the seriousness of Bilharzia and other diseases.” 16
Part of the overall problem in assessing disease in colonies, was the institute’s
structure and philosophy that were formed around the concept of “Tropical
Medicine.” John Farley discusses the United Fruit Company’s working relationship
with Harvard Medical School’s Department of Tropical Medicine. He notes that
the department was formed at Harvard because of the fear that tropical diseases
Howard Markel. “Lice, Typhus, and Riots on the Texas Border.” In When Germs Travel: Six
Major Epidemics That Have Invaded America Since 1900 and the Fears They Have Unleashed,
(New York: Pantheon Books, 2004), 122.
12
Ibid, 113-14.
13
Ibid, 139.
14
Farley, 121.
15
Farley, 137.
16
Ibid, 139.
11

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could arrive in the port city of Boston. 17 The United Fruit Company was the largest
American company of its kind operating in Latin America and was very concerned
about its interests in the tropics. The company felt that proper research should be
done in the colonies. Harvard insisted that the real research should be done in
Boston because researchers ’mental capacity could be diminished by working in
the tropics. 18 As a result, remote authority could overrule local expertise and
transmit incorrect theories and beliefs.
The imposition of remote authority on local agents can also be seen in British India,
where the “political and social impact [of a late 19th century plague outbreak] was
felt long before … mortality had reached its peak.” 19 This command was caused by
the governmental authorities in Britain, who formed policies in response to the fear
of the plague coming to Britain. 20 Compounding this was the medical profession’s
self-image as “the principal agents and overseers of the British administration …
and the Indian Civil Service were entrusted with overall control of plague
operations.” 21 British control was so overwhelming that important social structures
based on caste and religion were ignored and seen as merely superstitious. 22
As noted earlier, women in India were afraid of going to hospitals, in part because
methods for preventing the spread of plague were so aggressive that “plague
measures anticipated the arrival of the epidemic itself.” 23 Furthermore, rumours
began to circulate, and violent public reactions displayed a lack of confidence in
Western medicine. 24 For Indian women, the biggest issue was that most of the
doctors were male and white. Arnold points out that searching the female body for
the plague was considered the equivalent of sexual molestation. 25
The absolute failure of colonial powers to recognize social and cultural values can
be seen in the British colonization of Egypt. Historian Hibba Abugideiri points out
that, in the British initiative to modernize Egypt, gynaecologists extended their
focus on the female body to activities in the home. 26 The Egyptian nation was
generally viewed by the British as backward and in need of modernization to fulfill
its potential. Egyptian doctors with their Western-based medical training were seen
Ibid, 124-28.
Ibid, 129.
19
Arnold, 202.
20
Ibid, 205.
21
Ibid, 208.
22
Ibid, 204.
23
Ibid, 237.
24
Ibid, 218-24.
25
Arnold, 214.
26
Hibba Abugideiri. “Egyptian Doctors and Domestic Medicine: The Forging of Republican
Motherhood.” In Gender and the Making of Modern Medicine in Colonial Egypt, (Burlington, VT:
Ashgate, 2010), 187.
17
18

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as vital for this transformation. Part of this transformation would be the radical role
that doctors would play in modifying the domestic roles of Egyptian women.
Traditionally Egyptian midwives were in the home assisting with breastfeeding and
childcare, but the doctors overruled this practice and encouraged the “rethinking of
the family and gender roles.” 27 This domestic overhaul of Egyptian culture was
based on Victorian bourgeois ethics. 28 The identity of the “Modern Egyptian
Woman” was to be radically changed based on her motherhood, domestic role,
grooming, and etiquette. Medical advice declared that the mother alone should
breastfeed her child and the employment of midwives was prohibited. 29 It was also
stated that the mother must teach and supervise her child as much as possible and
oversee much of the domestic work done in the home. 30 The drive to build Egypt
as an unequivocal modern state was so encompassing that the “gendered and
moralistic view of doctors as regulators of women’s social behaviour was a
distinctly modern phenomenon.” 31
From today’s perspective it certainly seems outrageous that medical professionals
could have interfered so drastically into the family home. However, the real issue
is about power, and women have typically had a lack of it, even to the present day.
Colonialism was about power imbalance. It could dictate terms to people who were
poor and impoverished. It could take advantage of people from around the world
with its mantra of technologically modernizing the world by sheer force. The
wrongfully obtuse construction of “racial” otherness reinforced economic
imposition. Perhaps the greatest injustice was the colonizer’s inability to see that it
was their actions that gave rise to the spread of some diseases. It is much more than
ironic, that the Hippocratic Oath, (interpreted as to do no harm or injustice to the
patient), which Western medicine tries to emulate so much, was not upheld and
indeed the colonial powers did much harm. 32

Ibid, 188.
Ibid, 194.
29
Ibid, 200-04.
30
Ibid, 205-11.
31
Ibid, 187.
32
Markel, 140.
27
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BIBLIOGRAPHY
ABUGIDEIRI, HIBBA. “Egyptian Doctors and Domestic Medicine: The Forging of
Republican Motherhood.” In Gender and the Making of Modern Medicine
in Colonial Egypt, 187-220. Burlington, VT: Ashgate, 2010.
ANDERSON, WARWICK. “No Place for a White Man.” In The Cultivation of
Whiteness: Science, Health, and Racial Destiny in Australia, 73-94. New
York: Basic Books, 2003.
ARNOLD, DAVID. “Plague: Assault on the Body.” In Colonizing the Body: State
Medicine and Epidemic Disease in Nineteenth-Century India, 200-39.
Berkeley: University of California Press, 1993.
CHAKRABARTI, PRATIK. Medicine and Empire 1600-1960. New York: Palgrave
Macmillan, 2014.
FARLEY, JOHN. “Into the 1930’s: Economics of Disease.” In Bilharzia: A History
of Imperial Tropical Medicine, 116-40. New York: Cambridge University
Press, 1991.
MARKEL, HOWARD. “Lice, Typhus, and Riots on the Texas Border.” In When
Germs Travel: Six Major Epidemics That Have Invaded America Since
1900 and the Fears They Have Unleashed, 113-40. New York: Pantheon
Books, 2004.

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