MEDICINE IN THE SERVICE OF COLONIALISM: MEDICAL CARE IN PORTUGUESE AFRICA 1885-1974

This study of Portuguese colonial medicine as a social institution reveals it to have had effects that were far from beneficial. Medicine was a powerful tool for social control in the colonies, promoting acquiescence of the population before Portuguese authority. The health services had the power to enforce physical examinations and blood tests, to require vaccinations and prophylactic treatments for various diseases and even to confine sick individuals by force. Medical care was one of the major settings in which Africans encountered Portuguese authority, priming the pump for other incursions and defusing hostility to the Portuguese through occasional successes. It also facilitated European colonial penetration by protecting soldiers, administrators and settlers against disease.; At several junctures, foreign criticism was a major stimulus to Portuguese colonial medical efforts. When criticized for the brutality of their colonial regime, they attempted to prove their humanity to the world through such high profile medical activities as the publication of medical journals and mass vaccination campaigns. Foreign pressure similarly made trypanosomiasis a major focus of medical activity, although in Mozambique it posed only a minimal threat to humans.; When the desire to extract capital more efficiently from the colonies necessitated a dependable supply of African labor, medical efforts to keep workers healthy and fecund were introduced. Efforts to control animal trypanosomiasis were also motivated by economic considerations.; When Portugal resisted surrendering its colonies after World War II, it was criticized for the inadequacy of its medical programs as part of the campaign for decolonization at the United Nations. To reinforce their claim to colonial legitimacy, they rebuilt the Institute of Tropical Medicine and established medical schools in Angola and Mozambique. To increase support in Africa, they also examined or vaccinated a large portion of the population every year. Liberation movements responded with their own extensive medical programs, thereby making medical care one of the battlegrounds for the liberation struggle.; Medical care served largely as a tool for domination, facilitating penetration of the colonies, control of the population and economic development, while being used as a justification to the international community for the Portuguese colonial regime.