Networks in Tropical Medicine: Internationalism, Colonialism, and the Rise of a Medical Specialty, 1890–1930 (review)

Deborah Neill’s Networks in Tropical Medicine covers ground that has been well trodden by historians of colonial medicine in Africa. And yet it is groundbreaking in that it challenges us to rethink the relationship between the emerging discipline of tropical medicine and the policies and practices of colonial health authorities.

Neill’s immediate concern is in demonstrating that tropical medicine researchers, while serving the interests of colonial governments, operated within an emerging international community of tropical disease experts who shared knowledge, attended international conferences, published in specialist journals across national boundaries, and engaged in joint research enterprises. She further argues that the ideas that evolved within this “epistemic community” of international tropical disease experts played a critical role in shaping health policies in colonial Africa across colonial boundaries. There was thus a remarkable degree of uniformity in colonial medical policies among health authorities in French, German, Belgian, and British colonies. She illustrates these external influences by looking in turn at the history of colonial urban health policies and at efforts to understand and control sleeping sickness epidemics. In order to do this, she necessarily covers ground that, as noted above, has been tread by others. Sleeping sickness campaigns, after all, is one of the most thoroughly researched topics in African colonial medical history.

Yet her book is nonetheless original. First, while most histories of sleeping sickness focus on the experience of particular colonies, Neill reveals the ways in which knowledge and practices moved across colonial borders. Second, previous work on sleeping sickness has looked at sleeping sickness control as a public health exercise, designed to stop the spread of epidemics. Neill looks at this aspect of the campaigns, but she is also interested in sleeping sickness as a research enterprise. She thus builds on Helen Tilley’s work. By doing so she is able to add fresh details to the research that was being conducted collaboratively by European scientists looking for new treatments for sleeping sickness. Her description of Paul Erhlich’s drug trials in Uganda reveals the extent to which tropical disease experts experimented on Africa bodies, often with disastrous results.

Neill’s book is also original in that it opens a social space between the emerging international tropical medicine community and the community of colonial health officials operating on the ground in Africa. As much as the two groups were bed-fellows, tropical disease experts were in many ways akin to more recent networks of scientific experts who move among academic institutions in the United States and Europe and field sites and laboratories in developing countries. Like more recent scientific networks, the tropical medicine community represented a group of medical experts who developed ideas and theories and proposed medical and public health policies based on only limited firsthand knowledge or experience within African conditions. Neill’s study thus causes us to rethink Sunil Amrith’s claims regarding the changing nature of colonial expertise during the first half of the twentieth century. Amrith suggests that colonial authorities were grounded in the knowledge of particular places and that a shift in the nature of expertise occurred during the 1930s as part of what he calls the “decolonization of international health.” Experts who had technical knowledge about particular problems but little experience with the areas in which they worked replaced officials with local knowledge. There is no doubt some truth to this claim, yet Neill’s work reveals the extent to which tropical medicine specialists had little local experience even before World War I.

I do have a couple of issues with Neill’s account. First, while she successfully demonstrates the influence that tropical medicine as a discipline had on colonial medical practices in Africa, she does not explore how the experience of fighting disease in Africa may have informed the discipline of tropical medicine. In particular, the colonial setting permitted the...