F. Dube: Public Health at the Border of Zimbabwe and Mozambique, 1890–1940

Public Health at the Border of Zimbabwe and Mozambique, 1890–1940. African Experiences in a Contested Space

Dube, Francis
African Histories and Modernities
XI, 258 S.
€ 96,29
Reviewed for Connections. A Journal for Historians and Area Specialists by
Geert Castryck, ReCentGlobe, Universität Leipzig

Public Health at the Border of Zimbabwe and Mozambique, 1890–1940 is a well written and thoroughly researched book about various dimensions of “health” in the Zimbabwe-Mozambique border region during the protracted period of colonial encroachment. Francis Dube assesses the interplay between health conceptions and mobilities in the region, colonial preventive as well as curative health policies, and an integrated region separated by a territorial border.

The book is organized in nine chapters and three parts. After an introduction (chapter 1), in which the author announces an innovative theoretical, methodological, and interpretative approach to borders in relation to colonial public health, part I “Life and Health before the Border” (chapter 2) captures the healthscape in what would become a border region at the time of colonization. Based on knowledge of the field, literature, and contemporary European observation, the author pieces together how environment, seasonal fluctuations, grazing needs, ritual/medical expertise, as well as kin and ethnic relations shaped how people in the region dealt with health hazards – and how this, to some extent, would continue to inform how these people would make sense of healing.

Part II “Life and Health with the Border” (chapters 3 to 4) primarily focuses on the imposition of colonial rule and the establishment of the border. In an attempt to underscore the agency of local populations, the author stresses how people make borders permeable through their actions. Even when border zones are sprinkled with landmines (p. 78–79), the action of crossing borders makes them permeable. Taxation, land alienation, forced labour, and dipping fees stand at the opposite – at the colonizers’ – end of the equation.

Part III “The Border and Public Health” (chapters 5 to 8) is organized following specific public health concerns: sleeping sickness, smallpox, sexually transmitted diseases, and the provision of health services to rural Africans.

Chapter 5, on sleeping sickness, a disease transmitted by tsetse flies, allows the author to focus on landscape, environment, age-old experience with this disease in the region, the precedence of veterinary over human medicine concerns, and mobility as well as the prevention of mobility as opposing health measures.

The smallpox case (chapter 6) draws attention to inoculation campaigns, to the colonial priority to protect whites and labour rather than the population as such, to the bureaucratization of public health, to the treatment of Africans as a collective rather than as individuals (reflected in ignoring sterility procedures while inoculating), to the role of African indigenous churches, and to the resistance and distrust against government-led preventive health measures.

With sexually transmitted diseases (chapter 7), colonial morality discourses enter the scene. The author addresses the tension between public and individual health. The paradox between controlling mobility and controlling settlement as well as the role of missionaries and their view on morality could have been more thoroughly developed.

Chapter 8, on the provision of health services to rural Africans, is the most ambitious and potentially innovative one. Already touched upon before, here the tension between refusing preventive public health measures – prone to controlling mobility and intruding the body – and being open to modern “western” medicine when it comes to curing ills, is fully appreciated. The author addresses both the efficiency – seen from a scientific medical point of view – and the deficiencies – seen from a holistic or spiritual point of view – of “western” medicine. The central role of Christian missions, rather than the colonial government, is highlighted, although relatively few missionary sources – and absolutely no Catholic sources – underpin this research.

Dube comes to the conclusion (chapter 9) that “Africans were not distrustful of Western medicine per se; they were distrustful of the methods of its delivery and what those methods represented and reproduced, that is, racism, coercion, paternalism, and control.” (p. 205–206) Overall, the author posits that refusal to colonial public health is tantamount to resistance against colonialism as such. Furthermore, the British racist conviction of supremacy over colonized Africans was reiterated in a watered-down way in the British looking down on Portuguese colonizers.

The author and the publishing house claim that this book is the first major work to explore the utility of “the border as a theoretical, methodological, and interpretive construct for understanding colonial public health” (p. 2). Despite extensive research about the centrality of territoriality and borders for understanding colonialism in general, despite considerable literature assessing the spatial dimension of colonial health politics within colonies, and despite a growing literature on cross-border interactions during the colonial period, I agree that the border between colonial territories has not yet received sufficient attention in research on colonial public health. The systematic focus on the Zimbabwe-Mozambique border region, on mobilities and obstacles across the border, and on cross-border comparison is, therefore, a valuable contribution to the research on colonial public health. Nonetheless, the central findings of the book, regarding openness towards curative “western” medicine while distrusting the colonial government, have not much to do with the border.

Moreover, I am not sure where the theoretical or methodological innovation lies. The author reaches the same conclusions as other historians before him: colonial health politics as a tool of colonization, as a means to protect white settlers and labour, as inherently contradictory in facilitating labour migration while curtailing mobility for public health reasons, as undermining African cultural-political orders, as a Christian missionary domain, as a legitimation for intrusive control on mobility, residence, and bodies, and as an entry point to intervene in landscapes and environment. The strength of this book is the integration of so many aspects in one study rather than its contribution to border studies.

The border remains important for the demarcation of the study area and plays a role in the interpretation when it comes to cross-border movement and comparison. Yet, the comparison is lopsided, with considerably more attention going to the Zimbabwean side of the border. The author has used Zimbabwean as well as Mozambican sources, but the references contain only one (!) publication in Portuguese, used for a sketch of the region half a millennium ago. And when there is a subchapter profoundly zooming in on the Mozambican side of the border (chapter 3, section on Anglo-Portuguese Relations), it is based on an anglophone Protestant missionary perspective.

To be clear, this does not undermine the thoroughness and worth of this research. It does mean, however, that the interpretative and methodological innovation is not so much the Zimbabwe-Mozambique border binary, but rather the reaching out for “external” factors playing into Zimbabwean colonial health politics, which encompasses South African labour migration as much as connections of people and missionaries across the Zimbabwe-Mozambique border. Or put otherwise, the strength of this research is not the focus on the border, but the analytical blurring of the Zimbabwe territory.

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