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Journal of the History of Medicine and Allied Sciences 59.1 (2004) 167-169



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David McBride. Missions for Science: U.S. Technology and Medicine in America's African World. New Brunswick, New Jersey, Rutgers University Press, 2002. 308 pp. $40.

David McBride's From TB to AIDS: Epidemics among Urban Blacks since 1900 (Albany: State University of New York Press, 1991) provided one of the best surveys on the subject. Indeed, McBride's footnotes and bibliography are a virtual map of published and unpublished sources on the matter, and most books and articles dealing with the history of African American health and health activism in the twentieth century make at least some reference to McBride. If the field, which is currently experiencing vigorous growth generated by contemporary concerns, may be said to have a canon, From TB to AIDS (regrettably out of print) has certainly taken its place within it.

A decade later, McBride has given us an analysis that should spawn another round of critical explorations into black health. Missions for Science is not a survey but is broad in scope, comparatively examining the Black Belt counties of the U.S. South, Haiti, Liberia, and the Panama Canal Zone. The questions McBride asks are:

What specific technologies and medical resources were transferred by U.S. government, philanthropy, and industries to these black population centers and why? How did the professed aims of U.S. technical projects, public health, and military activities differ from their actual effects and unforeseeable consequences in the health and social lives of populations in these four Atlantic regions? Were U.S. technical experts and programs in the black Atlantic societies able to sustain their advances for use by the broader, indigenous populations and institutions of these regions? Or, did the U.S. technical transfer amount to a form of hegemony—one in which regional leaders endorse the technology to reinforce a disguised dependency and anti-democratic rule? Finally, what lessons may we learn from the history of technology and medicine in these four geographic regions of the Atlantic world as we open a new century? (p. 6) [End Page 167]

Not surprisingly, as the penultimate of these questions most clearly implies, an inquiry into the politics of U.S. technology transfer in the black Atlantic world leads straight to the doorstep of American empire. For three of McBride's case studies, empire is obvious. In the Panama Canal Zone, the U.S. economic presence (primarily in the fruit cultivation and export industry) began in the 1860s and culminated with the formation of the infamous United Fruit Company in 1899. Nineteenth-century commercial hegemony in Central America was driven by political concession, technological innovations in transportation (improved shipping and railroads), and the availability of cheap labor in the form of indigenous workers and Chinese, Irish, European, and especially black West Indian immigrants. Under the influence of the Monroe Doctrine, the politics of U.S. intervention in Cuba and the Philippines, and the policies of Teddy Roosevelt and his administration, mere commercial hegemony soon gave way to formal occupation by the U.S. military and industrial interests during and after the construction of the Panama Canal.

Haiti, the nineteenth-century beacon of promise for black liberationists and the bête noire for proslavery forces, was the object in the early twentieth century of U.S. military occupation supported by a professional and philanthropic civilian presence. What McBride calls U.S. "techno-nationalism"—the Social Darwinist "idea that U.S. science could impart miraculous progress in the 'backward'" (p. 81) nations in its sphere of influence—swept up Haiti as it had Cuba and the Panama Canal Zone. In Haiti, techno-nationalism and military imperative dictated that a U.S.-dominated public health infrastructure be ensconced, to the detriment of the nation's already existing medical professional class. As in the Panama Canal Zone, U.S. technological transfer and hegemony involved commercial interests (initially, Firestone Rubber, and later, mining concessions given to the United States and other...

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