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International professor recounts history of physicans in Africa

Ryan Reiss/Daily
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By Tom McBrien, Daily Staff Reporter
Published April 16, 2014

Politicians usually come from a few typical professions: law, business and community service, to name a few. But a large, educated class of people in our society — doctors — rarely become politicians.

In his lecture “The Doctor Who Would Be King: Medical Utopias in the Colonial World,” Dr. Guillaume Lachenal discussed cases in which doctors were given control of certain regions of colonial Africa in the 20th century. Lachenal, a medical historian visiting from the Université Paris Diderot, discussed the origins and impacts of these colonies.

For the 20th-century colonial project, one of the most costly dangers was African trypanosomiasis — a fatal disease caused by a parasite transmitted by the tsetse fly, also known as sleeping sickness. This, Lachenal said, along with accusations by other European nations of unsanitary conditions, led the French to begin a massive health campaign in Cameroon in 1925.

Despite early successes of this campaign, doctors still had one major complaint: they could not completely eradicate the disease due to the reticence of politicians, who were unwilling to enforce radical measures such as stopping forced labor and slowing trade. Due to continued outcries, Dr. Jean David was appointed Doctor-Captain of the Medical Region of Haut-Nyong in French Cameroon in 1939.

Lachenal said David’s original changes had beneficial effects on the local population’s health. Introducing cocoa, cattle, soybeans and novel treatment and screening techniques reduced mortality due to disease sharply. Statistical analyses of these benefits were published worldwide and the experiment was painted as a success.

But Lachenal’s research suggests that, despite the health benefits, the Medical Region may not have been quite the utopia the French claimed.

“The restriction of their freedom to be inefficient and wasteful of natural resources has given to the people of Anchau, freedom from much of their former ill health — which is surely to their benefit,” reads a quote from The Lancet about a similar colony controlled by the British.

Lachenal said despite the fact that the measures taken improved health, this seemed to imply some sort of unwillingness from the local population.

In addition, the health success of the colony was short-lived. Rubber shortages during World War II combined with labor shortages convinced David to reestablish forced labor. This meant that locals were entering the forests for days before coming back to the village and exposing themselves to others in the marketplace: a perfect combination for a sleeping sickness epidemic.

Quickly after this turn of events, statistics from the colony stopped being collected and published. The entire area became disease-ridden, and David died shortly after the war.

Lachenal said the legacy of the colony is mixed. On one hand, it improved the people’s health for a certain amount of time. On the other hand, many of the doctors were left broken and despondent.

“For once, they could not blame their failures on the administration and the bureaucracy and the politicians, because they were the politicians,” Lachenal said.

It is also rumored that David and one of his main lieutenants, Dr. Henri Koch, had gone mad by the end of their terms, though the record is unclear.

“This story can be taken as a parable if you want,” Lachenal said. “Today’s global health is also a story of hope, full of success stories and charismatic doctors. But we also risk doctors' losing their critical voices when they touch on power and glory.”

Medical student Maia Anderson said she appreciated the lecture.

“I’ve always liked learning about the history of medicine and I think that it isn’t taught enough in medical school or in undergrad, even, and I think it’s awesome that there’s a big push for that here,” she said.

“I think that there are a lot of stories like this that are buried and yeah we do go and travel around and we think it’s a great idea to go places and teach people to have better hygiene. But what we saw is that doctors aren’t fit to govern all the time. Good intentions are not always enough.”