The Comparative History of Sleeping Sickness in East and Central Africa,1900–1914

I would like to thank the Wellcome Trust for supporting my fellowship at the Wellcome Unit in Manchester during which time this paper was completed. An earlier version of some of the ideas in this paper was published as: Worboys M. , “British colonial medicine and tropical imperialism: A comparative perspective”, in van Heteren G. M. de Knecht-Van Eekelen A. and Poulissen M. J. D. (eds), Dutch medicine in the Malay Archipelago, 1816–1942 (Amsterdam, 1989), 153–67.

Sandwith F. M. , “What we know about sleeping sickness”, Medical press, cxlvi (1912), 402–6, p. 405. The trypanosome is the parasitic protozoan recognized in the early 1900s as the necessary cause of sleeping sickness.

Pyenson L. and Sheets-Pyenson S. , “Comparative history of science in an American perspective”, History of science in America: News and views, iii/3 (1985), 3–7.

For example, the recent conference of the British Society for the History of Science on “Getting the Big Picture”. See report, BSHS newsletter, no. 36 (September 1991), 14–17.

Examples in the history of science include: Harwood J. , “National styles in science: Genetics in Germany and the United States between the World Wars”, Isis, lxxviii (1987), 390–414; Kevles D. , In the name of eugenics: Genetics and the uses of human heredity (New York, 1985); Adams M. B. (ed.), The wellborn science: Eugenics in Germany, France, Brazil and Russia (Oxford, 1990), esp. pp. 217–31. For the history of medicine see: Fox D. M. , Health policies, health politics: The British and American experience, 1911–1965 (Princeton, N. J., 1986); Fox D. M. and Lawrence C. J. , Photographing medicine: Images and power in Britain and America since 1840 (London, 1988); Berlant J. L. , Profession and monopoly: A study of medicine in the United States and Great Britain (New York, 1975); Pickstone J. V. , “The professionalization of medicine in England and Europe: The state, the market and industrial society”, Nihon Ishigaku Zasshi, xxv (1979), 550–520.

Pyenson L. , “Pure learning and political economy: Science and European expansion in the age of imperialism”, in Visser R. P. W. (eds), New perspectives in the history of science (Amsterdam, 1988), 209–78.

Palladino P. and Worboys M. , “Science and imperialism”, Isis, lxxxiv (1993), 91–102.

MacLeod R. and Lewis M. (eds), Disease, medicine and empire (London, 1988); Arnold D. (ed.), Imperial medicine and indigenous societies (Manchester, 1988).

Reingold N. and Rothenberg M. (eds), Scientific colonialism: A cross-cultural comparison (Washington, D.C., 1987); Home R. W. and Kohlstedt S. G. (eds), International science and national scientific identity (Dordrecht, 1991).

Farley J. , Bilharzia: A history of imperial tropical medicine (Cambridge, 1991); cf. Vaughan M. , Curing their ills: Colonial power and African illness (London, 1991).

Pan-African studies include: Ford J. , The role of trypanosomiases in African ecology: A study of the tsetse fly problem (Oxford, 1971); McKelvey J. J. , Man against tsetse: Struggle for Africa (London, 1973); Scott H. H. , A history of tropical medicine (London, 1939). Details of single colony studies are given in the appropriate sections.

Beck A. , “Medicine and society in Tanganyika, 1980–1930: A historical inquiry”, Transactions of the American Philosophical Society, lxvii (Suppl. 3) (1977), 5–37; MacKenzie J. M. , “Experts and amateurs: Tsetse flies, nagana and sleeping sickness in East and Central Africa”, in MacKenzie J. M. (ed.), Imperialism and the natural world (Manchester, 1990), 187–212, pp. 197–8; also see Ford, op. cit. (ref. 11), 53.

This section is heavily based on: Bell H. Hesketh , Uganda: A report on measures adopted for the suppression of sleeping sickness in Uganda (Colonial Reports, Misc. no. 65; London, 1909); Davies J. N. P. , “The cause of sleeping sickness?”, East African medical journal, xxxix (1962), 81–99 and 145–60; Beck A. , A history of the British Medical Administration of East Africa, 1900–1950 (Cambridge, Mass., 1970); Soff H. G. , “Sleeping sickness in the Lake Victoria region of British East Africa, 1900–1905”, African historical studies, i (1969), 255–68.

Proceedings of the First International Conference on Sleeping Sickness, British Parl. Papers, 1908, Cd. 3778; lxxxvii, 530. Also see: Ford, op. cit. (ref. 11), 238–53. It is possible that other tsetse fly species were involved in some areas. Several new species of trypanosome were identified in the 1900s; however, the other main form of the disease (Trypanosoma rhodesiense), now known to produce an acute form of the disease in humans, was not identified until 1910–11.

Todd J. L. , “The distribution, spread and prophylaxis of ‘Sleeping Sickness’ in the Congo Free State”, Transactions of the Epidemiological Society of London, xxv (1905–6), 1–30.

Sandwith , op. cit. (ref. 2).

Bruce D. , “Sleeping sickness in Uganda”, Journal of the African Society, vii (1908), 249–59.

Worboys M. , “The emergence of tropical medicine: A study in the establishment of a scientific specialty”, in Lemaine G. (eds), Perspectives on the emergence of scientific disciplines (The Hague, 1976), 75–98.

See Davidson A. (ed.), Hygiene and diseases of warm climates (Edinburgh, 1893), 503–10.

I have deliberately avoided saying who made this proposition as it is still disputed. See: Boyd J. K. S. , “Sleeping sickness: The Castellani-Bruce controversy”, Notes and records of the Royal Society of London, xxviii (1973), 93–110.

Scott , op. cit. (ref. 11); Foster W. D. , A history of parasitology (London, 1965); Garnham P. C. C. , “Britain's contribution to tropical medicine”, The practitioner, cci (1968), 153–61.

Worboys M. , “Tropical diseases”, in Bynum W. F. and Porter R. (eds), Companion encyclopaedia of the history of medicine (London, 1993), 512–36; Harden V. A. , “Rocky Mountain spotted fever and the development of the insect vector theory, 1900–1930”, Bulletin of the history of medicine, lix (1985), 449–60; Chwatt L. J. Bruce , “Ronald Ross, William Gorgas and malaria eradication”, American journal of tropical medicine and hygiene, xxvi, Supplement (1977), 1071–9. On the wider threat of flies see: Rogers N. , “Germs with legs: Flies, disease and the new public health”, Bulletin of the history of medicine, lxiii (1989), 599–617. On changing European health in the tropics see: Curtin P. D. , Death by migration: Europe's encounter with the tropical world in the nineteenth century (Cambridge, 1989).

McKelvey , op. cit. (ref. 11), passim.

Minutes of the Royal Society Tropical Diseases Sub-Committee. Letter from the Royal Society to the Colonial Office, 30 May 1906. This letter was in response to a recommendation from the Liverpool School that the Colonial Office pursue quarantines and the control of population movements.

Ibid.

Thomas H. Wolferstan , Report on trypanosomes, trypanosomiasis and sleeping sickness (Liverpool, 1905).

Bell Hesketh , op. cit. (ref. 13), 10.

The lancet, i (1910), 263: Bell Hesketh , op. cit. (ref. 13), 10.

Bell Hesketh , op. cit. (ref. 13), 7–10.

Soff , op. cit. (ref. 13), 260–8.

Report of the Interdepartmental Committee on Sleeping Sickness [known as the Desart Report], British Parliamentary Papers, 1914 Cd. 7349; xlviii, i; idem, Evidence of …, Cd. 7350; xlvii, 29. The work of this Committee is discussed in MacKenzie, op. cit. (ref. 12), 199–204.

Desart Report: Evidence (ref. 31). For Bruce's views see pp. 244–5.

McKelvey , op. cit. (ref. 11), passim.

This section is almost entirely based on Maryinez Lyons, “The colonial disease: Sleeping sickness in the social history of northern Zaire, 1903–1930”, unpublished Ph.D. thesis, University of California, 1987. Also see: Lyons M. , “Sleeping sickness, colonial medicine and imperialism: Some connections in the Belgian Congo”, in MacLeod and Lewis, op. cit. (ref. 8), 242–56; idem, “Sleeping sickness epidemics and public health in the Belgian Congo, 1903–1914”, in Arnold (ed.), op. cit. (ref. 8), 105–24; idem, “From ‘death camps’ to cordon sanitaires: The development of sleeping sickness policy in the Uele district of the Belgian Congo, 1903–1914”, Journal of African history, xxvi (1985), 69–91. Since this paper was completed a monograph has been published: Lyons Maryinez , The colonial disease: A social history of sleeping sickness in northern Zaire (Cambridge, 1992).

Cf. Curtin, op. cit. (ref. 22), passim.

The Liverpool journalist E. D. Morel had been the main critic of the Congolese state and it is clear that Leopold saw action on colonial health as one way of repairing the tarnished image of Belgian colonialism. There were then political advantages in choosing Liverpool; indeed, one member of the Liverpool School thought that Leopold's support would be interpreted as a bribe. Lyons in Arnold (ed.), op. cit. (ref. 34), 182–3.

Lyons, Ph.D. thesis (ref. 34), 107.

Musambachime M. C. , “The social and economic effects of sleeping sickness in Mweru-Luapula, 1906–1922”, African economic history, x (1981), 151–83.

The important work of Jamot in French Equatorial Africa (Gabon, Congo and the Central African Republic) did not begin until the end of the period discussed here so further comparative dimensions cannot be developed, though the opportunities for work on the later period are great on this disease and many others. Roubard E. , “Les précurseurs dans la lutte contre maladie du sommeil en Afrique Noire français (1908–1930)”, Presse médicale, lxiii (1955), 1547–8. Mention should also be made of Portuguese efforts in the island colony of Príncipe; see McKelvey , op. cit. (ref. 11), 115–21.

This section is heavily based on: Beck, op. cit. (ref. 12).

Quoted in Clyde D. F. , “Malaria control in Tanganyika under German administration: Part I”, East African medical journal, xxxviii (1961), 27–42, p. 39.

Idem, “Part II: Mass chemoprophylaxis in Dar es Salaam”, ibid., 69–82.

Brock T. D. , Robert Koch: A life in medicine and bacteriology (Madison, 1988), 255–6.

On the wider economic and social context see: Beck, op. cit. (ref. 12), 22–29.

Indeed, it soon became an exclusively British agency — the Tropical Diseases Bureau, which had a wider disease and professional remit.

Desart Report: Evidence (ref. 31), 256.

It has been suggested that the Ugandan outbreak might have been due to the more virulent Trypanosoma rhodesiense. Even if this could be shown to have been the case, and there are good reasons for doubting it, the claims made in this article would be unaffected. What matters in my argument is how the disease was understood at the time.