Missions for Science: U.S. Technology and Medicine in America's African World (review)

David McBride's subtitle, "U.S. Technology and Medicine in America's African World," indicates the scope of his project. By "America's African World," he means the Southern states, the Panama Canal Zone (where most of the construction workers were black West Indians), Haiti, and Liberia. What neither the title nor the subtitle says is that the book is about the failure of American technology and medicine to improve the health or the standard of living of people of African descent. In McBride's words, "The mission for science that propelled the United States to the top of global political leadership contributed to the failures of the Atlantic world's two oldest black republics" (p. 7).

The story of the South is a familiar one. McBride recounts how the South was dominated by an elite of white plantation owners, how it preferred monoculture to industrialization, and how its elite had little interest in the health of black slaves before the Civil War, or in that of the poor—black or white—after the war, since there seemed to be a surplus of cheap labor. Well into the twentieth century, black Southerners suffered from the highest disease and death rates in the nation, while the federal government's efforts were focused on research rather than public health.

The Panama Canal project is usually described in reverential tones as the triumph of American science and engineering over a hostile environment that had defeated the French. Special praise is reserved for the doctors and sanitation officials who conquered yellow fever and suppressed malaria. McBride does not dispute the medical and engineering successes of the canal builders, but he faults them for discriminating against their black workers and for neglecting the health of the surrounding nation of Panama.

In contrast to the South and the Canal Zone, which figure prominently in most American histories, Haiti and Liberia are largely ignored. Haiti was invaded by U.S. troops in 1915 and was ruled by a military government for two decades thereafter. American military and civilian officials attempted to justify their invasion by building roads and starting campaigns against syphilis and yaws. In doing so, however, they sidelined the Haitian physicians, nurses, and midwives, and ignored the many other health problems that afflicted the Haitian people, leaving them no better off than before the invasion. Even after World War II, when penicillin finally permitted the near-eradication of syphilis and yaws, other health problems continued unabated.

If Haiti was mistreated before World War II, Liberia was simply left to its own devices. The only meaningful American presence was the Firestone rubber plantation, an enclave project with its own hospital and medical staff that had no impact on the rest of the country. This changed suddenly in World War II, when Liberia became a strategic foothold in Africa. American public health measures there followed a similar path to that in Haiti, with a concentration on research on malaria to the neglect of other diseases and more necessary public health measures.

What McBride demonstrates in these four cases is that American technology in general, and medicine in particular, did little to alleviate the health problems of "America's African World," except in the Panama Canal Zone, where there was a clear American strategic interest involved. Instead, the goal of American tropical medicine was scientific research, partly to save American lives elsewhere (as in the Pacific in World War II), and partly to enhance the careers of the American scientists involved. Despite the rhetoric, American benevolence was, at best, the by-product of more immediate interests.

Worse was the effect that American policies had on the politics and peoples of Haiti and Liberia. Under American guidance, both ended up after World War II with dictators—Tubman in Liberia, and Duvalier in Haiti—who used modernization plans, imported technologies, and foreign assistance to increase their...