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Even though we live in a well-developed first world country there are many unknown medical mysteries that are still yet to be revealed, some examples include cures to cancer, why perfectly healthy people suddenly face a heart attack or a stroke, and how to prevent someone from becoming brain dead. However, in other places around the world, like Africa, sickness that we would consider to be minor, like a common cold, can result in a fatality to someone who is not receiving proper health care. While this issue of individuals dying from disease and illness has seen a decrease in the number of fatalities in developing nations, the number is still significantly higher than that of well developed countries. Although there have been many advances in medicine and technology available to those living in countries like Africa, these individuals still face a very high risk of contracting a disease or illness due to unsterile equipment, and lack of medication. A specific example of not being supplied with the proper medication is the AIDS Crisis that is currently still a predominant issue in Africa. AIDS is still a “epidemic that is killing millions” and even though there are many kinds of AIDS medication that have been used in the United States in order to “ease suffering and prolong life, they are so expensive and scarce that few people in Africa can get them” [1]. Since Africa has no access to these drugs, the country makes up “70 percent of the world’s 34 million HIV-infected people” [2]. This issue raises the historical question on why Africa has been supplied with such little health care in comparison to places like the United States that are trying to solve unknown causes of death, while Africa is simply trying to prevent the number of deaths from curable diseases.

Health care is a very serious issue that has been affecting places around the world, specifically countries in Africa for many years and is something that remains a problem to this day. Many diseases from animals, like mosquitos or parasites, the introduction of new people coming into Africa, during imperialism, and many other complications that can arise from something as simple as the common cold or a more serious health complication like childbirth that could possibly lead to the death of a mother or baby if the mother does not receive the proper assistance required. Along with not receiving the proper health care or medications, Africa is also not supplied with sterile environments or equipment that is needed for a women to give birth, or for someone to be treated for a disease. One of the main causes for this increase in disease and health care related problems for Africans dates back to the time of imperialism. The Imperialism of Africa took place from 1840 to 1914 and was considered “The Scramble for Africa” since many different nations were fighting over which African countries they could colonize. One of the biggest nations that had control over a majority of the regions in Africa was the British European powers. During this time of imperialism nations such as Europe were largely focused on controlling land in Africa and keeping their men and women safe from diseases, in return they withheld the majority of  health care from the natives and only supplied them with enough care to keep them alive and able to continue working for Europeans.

At the time of imperialism, the population of Europeans in Africa skyrocketed and around 1819 had an estimated 42,000 and in the following years up until 1870 the population had grown to 250,000. During this time, there was a significant increase in mineral discoveries in areas in South Africa that lead to a change in the economy. Due to this remarkable discovery, there was an increase in the number of Europeans that poured into Africa and they “experienced an unusually rapid concentration of population into urban areas” [3]. These workers had to work in very dangerous and hazardous conditions that ultimately lead to the cause of many diseases in South Africa. Some of these diseases that became widespread in Africa included malnutrition, tuberculosis, typhus, cholera, and typhoid V. Since these diseases became more prominent and were seen more often it was concluded that “these circumstances clearly facilitated the spread of epidemic diseases” throughout South Africa [4]. While all of these diseases affected many individuals the one disease that seemed to have to greatest epidemic problem was tuberculosis. The combination of “European immigrants with a high level of tuberculosis infection and Africans with high susceptibility to the disease set up a dangerous situation” especially during 1890 when these two populations were living and working in close proximity to one another [5].

Malaria is another life threatening disease that is caused by a parasite and is transmitted to individuals through the bite from a mosquito. During 1898 Dr. Koch traveled to a German colony in Africa to acquire more knowledge about this disease in order to provide Europeans with information on how to avoid contracting this disease. Through his findings Koch discovered that there is not only one type of malaria disease, there is actually four of which two are very rare. Koch also realized “there is a direct relation between the curve of the temperature and the development of the parasite” which makes Africa an ideal place for this disease to be common [6]. Figure 1 shows the many regions of Africa that experienced a malaria epidemic since Africa is such a prime climate location for this disease to become widespread. Koch believed this was something that was ideally important because it was then used to find out how much quinine should be used to treat malaria; this drug was used to “retard the parasites development but does not destroy it” [7]. This has led to European doctors having the ability to examine one’s blood and determine if they have been infected by the parasite that is malaria. This information was very valuable to Europeans living in Africa as they now had the ability to check themselves along with the natives to screen for malaria. Although malaria is not infectious Koch believes that malaria is “conveyed by mosquitoes” and it is important to Europeans to become aware of this [8]. However, Europeans were greatly concerned with their health rather than the health of the natives, many natives suffered from malaria without getting the any sort of treatment. This was because treatment was being saved for the Europeans that had contracted the disease, as they felt it was more important to provide themselves with adequate health care, and provide the natives with as little health care possible although just enough to keep them alive.

Figure 1: Map of Regions in Africa facing Malaria epidemic

Jaundice is a condition that affected those that lived in Africa, it is a disease that is caused by inflammation of the bile ducts and duodenum that results in a discoloration of the skin to a yellow color. Some of the symptoms of jaundice include that the individual “complains of loss of appetite, nausea, vomiting, and general feeling of malaise” of all which is accompanied by an increase in temperature to 100° F to 103°F [9]. Jaundice is not a fatal disease in fact are hardly any deaths recorded from contracting catarrhal jaundice. Europeans had noticed that there was a period of “greatest incidence was during autumn and winter months” and were very concerned as to what was causing this outbreak so that they could prevent it from effecting those in South Africa [10]. Jaundice was especially prevalent once it was “among colonies, but not just limited to the troops that were there” [11]. This indicates that not only did European troops that were stationed in South Africa become subject to this disease but so did the natives that lived there. When a jaundice epidemic broke out in 1902 the widespread contraction of jaundice was not simply limited to these troops that had been present in South Africa. In order for Europeans to remain in control over the natives of Africa much like they did with malaria treatment, they provided as little health care as possible to the natives simply to keep them alive and able to work on the plantations.

Smallpox, the plague, and ankylostomiasis were all diseases that had taken a toll on not only the natives but Europeans that were colonizing Africa as well during 1911. Europeans had begun to realize that in order for their colony to thrive it would require healthy natives that were capable of performing labor on plantations. The first disease that Europeans withheld health care from natives was smallpox. Figure 2 further displays the horrific disease of smallpox and how it not only effects adults but young children as well and provides insight as to how these individuals are forced to be put into isolation with no further medical attention because the Europeans want to eliminate any possibility they may contract this disease. Smallpox was a disease that “only attacked natives” and Europeans took “preventive measures adopted by German authorities were to isolate persons suffering from smallpox” as well as vaccinate the entire population [12]. Europeans isolated these individuals that had been affected by the disease in order to preserve their health and since only natives were affected this was fairly simple to do. Another disease that played a major role in preventive medicine in Africa was the plague, the plague was brought to Africa through trading vessels that had come from India that not only infected natives and Europeans but rats were also found to have contracted the plague. Measures were taken in order to prevent Europeans as much as possible from getting this disease that consisted of “isolating plague patients, careful burial of the corpses of those dying from plague, disinfection of the dwellings, keeping contacts under observations” and killing any rats due to the possibility they had this disease [13]. Since the plague was very hard to contain Europeans were convinced that they would never be free from the plague unless they completely separated natives from Europeans. Ankylostomiasis was a disease that had not effected any Europeans but did have consequences for the natives that were working among plantations. Europeans took many precautions since this disease had contributed to many deaths among natives, some precautions included “protection of water supply from infected, detection of all infected persons by microscopic examination of the feces, and giving the natives drugs that had a similar effect of alcoholic intoxication” [14]. Europeans gave natives little drugs or placed them into isolation while they were suffering or and in pain from a serious disease. The Europeans did this in order to keep natives alive and working for Europeans and doing anything in their power to keep themselves from contracting any disease.

Figure 2: Young child with smallpox

Not only did disease play a big role in how treatment and medication was given or withheld from natives of Africa, medicine and health care in general played a major role in the way the medicine was used as a form of colonial rule. Morocco is one region in particular that saw the effects of how imperialism changed the way medicine was used. Doctors in Morocco since the majority were French men often also worked as “agents of espionage, propaganda and socialization to capitalist rule, while medical systems provide social control and reproduce labor force to suit the needs of capital” meaning that they would provide natives with medical care in return for their labor [15]. They used health care and medicine as a way of boosting colonial capital by allowing workers to seek improvement within their health and by doing so created more supply from the added labor that was being put in my these individuals. Into 1912 there was a shift in the health care that was available to individuals of Morocco and colonial medicine became primarily focused on the propaganda they were trying to obtain in the past, and colonial medicine was no longer focused on health care, but rather social control. Medicine in Morocco had fallen under the control of the military and it became a mixture of “health care with political control in various doses” [16]. Much like the Europeans the French that controlled Morocco had given very little health care to natives and their primary concern became the health and well being of the French men living there. Moroccan natives had begun being treated at a much “lower level so that they could survive as unskilled labor, from which the maximum surplus value could be extracted” indicating that they were giving Moroccan very slim medical that only allowed them to be healthy enough to work and produce goods for the French [17].

Diseases were not the only medical treatment that was withheld from the natives of Africa, many general health care options were taken away from these individuals as well. Much like Morocco, Uganda was a country in Africa that had seen little to no health care that was available to them especially in obstetrics, or childbirth. Since Uganda had become such a prime and essential asset to the British they felt that it was important to set up some sort of medical association in this prime region. Although Uganda was still being offered very little when it came to health care for child bearing women, for these women since hospitals were so far out of reach due to the long travel it would require, many women were forced to give birth at their homes in “flea-ridden rooms or-a very much preferable place – in the banana plantations beneath the stars” [18]. Figure three provides a prime example of the conditions these women were forced to give birth in, the figure shows a mother outside lying on the ground with simply a mat underneath her and a stethoscope is the only equipment that has been provided to aid. These women were also not given the ability to have surgery if needed since at the time they believed “surgery could not be expected to do much for them” considering many factors including obstructed labor for several days [19]. The British believe that many of the woman are ignorant and that is why they give birth at home risking the chance of complications and if they were to simply go to the hospital, mother and baby would survive childbirth. What the British did not take into consideration was the fact that “the railway to Uganda had made only slight progress, and all the goods had to be carried up on men’s heads, and the journey from the coast was a three months’ march instead of a three-day pleasure trip” [20]. This trip was not something that could be done by a woman who is pregnant or worse in labor, and is an example of how Europeans withheld medical care from these women during the time of imperialism since they were primarily focused on the well-being of Europeans rather than sharing their knowledge of medicine with the natives of Africa.

Figure 3: Pregnant woman receiving medical care outdoors

Health care and medical treatment options have since improved in countries of Africa from the time of imperialism although medicine is still a major concern for the third world countries in Africa. While the numbers of deaths from many diseases like malaria, small pox, and AIDS have seen a decrease in numbers over the years, these numbers remain substantially higher than they should be for treatable diseases. Much like the Europeans did during imperialism with the withholding of medical treatment and medications, other well developed countries such as the United States are acting quite similar. The United States has developed many treatments and medications that have been used to treat diseases or at least make them bearable, although they still refuse to share these medications with places like Africa simply because they cannot afford these medications due to their low economic status. Since this is still an ongoing and present issue in Africa as well as many other places, these other well developed and striving countries should lend a hand to Africa and help these individuals seek the medical attention they deserve and ultimately continue to lower the number of deaths in this country from minor medical issues like an infection and childbirth.

Endnotes:

[1]”AFRICA’S AIDS CRISIS DRUGS CAN HELP, BUT PATIENTS CAN’T GET THEM.” 2000.The Record, Jul 17, L02. http://search.proquest.com/newsstand/docview/425153035/E3F0064D37064A95PQ/1?accountid=14902

[2] The Record, 1

[3] Hays, Jo N. 1998. The Burdens of Disease: Epidemics and Human Response in Western History . New Brunswick, NJ [u.a.]: Rutgers Univ. Press.  http://searchit.libraries.wsu.edu/WSU:WSU_everything:CP71168925440001451

[4] Hays, 201

[5] Hays, 202

[6]From The, London Times. 1898. “THE AFRICAN FEVERS.” New York Times (1857-1922), Sep 12,7.http://search.proquest.com/hnpnewyorktimes/docview/95598347/pageviewPDF/66D646BEAD54C43PQ/1?accountid=14902

[7] London Times, 1

[8]London Times, 2

[9]Mathias, H. B. “Jaundice In South Africa.” The British Medical Journal 2, no. 2281 (1904): 675-77.  http://www.systems.wsu.edu/scripts/WSUAll.plhttps://www.jstor.org/stable/pdf/20282007.pdf

[10] Mathias, 675

[11]Dolbey, R. V. “Epidemic Jaundice In South Africa.” The British Medical Journal 2, no. 2185 (1902): 1587. https://www.jstor.org/stable/pdf/20274289.pdf

[12]”Preventive Medicine In The Tropics.” The British Medical Journal 1, no. 2624 (1911): 883-84. http://www.systems.wsu.edu/scripts/WSUAll.plhttp://www.jstor.org/stable/pdf/25286186.pdf

[13] British Medical Journal, 883

[14] British Medical Journal, 884

[15]Paul, Jim. “Medicine and Imperialism in Morocco.” MERIP Reports, no. 60 (1977): 3-12. doi:10.2307/3011547. http://www.jstor.org/stable/3011547?seq=1#page_scan_tab_contents

[16] Paul, 7

[17] Paul, 7

[18]Cook, A. R. “East Africa And Uganda Branch. Obstetric Medicine In Uganda.” The British Medical Journal 1, no. 2789 (1914): 1281-283. https://www.jstor.org/stable/pdf/25310255.pdf

[19] Cook, 1281

[20] Cook, 1282

Illustrations:

Figure 1: Map of Regions in Africa facing Malaria epidemic http://www.traveldoctor.co.uk/africa.htm

Figure 2: Young child with smallpox https://www.flickr.com/photos/pahowho/9523370097

Figure 3: Midwife with woman who is pregnant and being seen outdoors

https://globalhealthafrica.org/2014/06/07/supporting-senegalese-midwives-and-birth-attendants-a-lesson-from-the-african-midwives-collective/

Geographic Focus: Africa, South/East Africa in particular

Search Terms: Medicine in Africa, Imperialism Africa, sub-Saharan*, Malaria*, Tropical Medicine, Jaundice*, Disease*, Medical Care

Primary Source Database: Search It, JSTOR

Primary Source Search Date Limiter: 1840 to 1914 , since this was the time of the “Scramble for Africa” which was when different nations were fighting over who would control what areas in Africa, more specifically Europeans and French

Historical Research Questions:

Question A: Did Europeans that had colonized parts of Africa in previous years not find it necessary to have some sort of medical assistance available?

Question B: How does Africa’s environment differ from other parts of the world making disease much more common there?

Course Theme Connection: This connects to the course theme of Humans and the Environment because the topic has to do with humans and how they are dying from many diseases that are present, as well as not being provided with adequate medical care or medication due to where they are located and who has control over the land