Science and Disease in Africa

The last quarter of the nineteenth century was an exciting chapter in the history of science and medicine. It was also the period when much of sub-Saharan Africa was formally colonized by Europeans and, indeed, the two phenomena were not unrelated. By the late nineteenth century, important developments in the areas of scientific, statistical, and epidemiological thought had combined with the development of specificity in disease etiologies and therapies to enable Europeans to penetrate and permanently settle the interior regions of the continent.

Late Victorians had great confidence that Cartesian science and new, rapidly evolving technology would provide humans with the means to reshape their environment to suit themselves. In fact, medical advances seemed to be elegant proof of this ability to overcome the dangers of the environment. During the 1854 expedition along the Niger, for example, the successful prophylactic use of quinine demonstrated that it was at last possible for Europeans to survive the onslaughts of malaria. Then around the turn of the century, new concepts of what constituted disease rapidly evolved, as did the role of the new expert health professionals - both develop ments having serious implications for the new African colonies.

Most important in the new science was the role of the laboratory, which became the real battlefield on which questions of life and death would be settled. Laboratories could be mobile, as they were soon to be in the new specialty of tropical medicine. Between 1860 and 1900, Joseph Lister, Louis Pasteur, and Robert Koch transformed forever our understanding of the relationships of humans and their disease-causing pathogens. The new sciences gave specificity to diseases whose etiologies could now be ascertained. With more concrete understanding of the pathology of a specific disease and knowledge of its particular cause, the pathogen or germ, scientists could think in terms of equally specific therapies (e.g., Paul Ehrlich's "magic bullet").

There was an unfortunate consequence, however, for these exciting developments prompted scientists involved in tropical health in Africa to cast aside most of the earlier theories of disease causation. Earlier ideas concerning the influences of environment on health, a view that stressed the relationships between humans and their environment, were overshadowed by the empiricism of the new laboratory science with its method of verifiable experiment. Thus, budding theories of the "social construction of diseases" were, by the turn of the century, almost entirely superseded by powerful theories of the "biological determinism of disease." The latter approach would dominate most medical and public health thinking throughout the colonial period.

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