Manson had in mind certain epizootics, such as rinderpest, which had swept through Eastern and Southern Africa in the 1890s, decimating cattle populations and leading to massive social and economic upheavals .
He was also concerned about an ongoing pandemic of sleeping sickness (African trypanosomiasis)—a disease transmitted by tsetse flies and fatal to humans unless treated—that had recently broken out in the territories surrounding Lake Victoria, including the Congo, Uganda, the Sudan, and Tanzania .
While their motives varied, they tended to be optimistic about the potential wealth of the new territories in terms of both natural resources and labor pools.
They also embraced a vague mandate to “civilize,” “improve,” and “develop” the populations they ruled, setting up governance structures that invested officials, usually unfamiliar with the regions, with far more political and cultural power than most Africans possessed .
Colonial efforts to create export economies had similar adverse effects on Africans’ health .
Whether people were enlisted in mining, infrastructure, or agricultural projects, they often had few occupational protections and succumbed to illnesses that resulted from their labors.The flies’ habitats had been transformed in the previous decades, bringing tsetses into closer proximity to humans and distancing them from some of the animals, especially cattle, on which they normally fed.Thus, in at least some regions, people became a convenient meal for the flies, increasing transmission rates and spreading the epidemic to new areas .Health activities took on an exalted role given this ethos of improvement since they were a visible and seemingly uncontroversial way to address the needs of the continent’s people.Unsurprisingly, medical projects often received a significant portion of development funds earmarked for social welfare, and medical personnel made up the majority of employees in the technical services of each colonial state [5, 6].These new ideas and techniques increased people’s faith that diseases could be mastered and human lives extended, if only the new knowledge were applied.By exploring the ethical dimensions of medicine in colonial Africa, we can begin to appreciate the moral complexity not only of past interventions but also of international health systems today, given their roots in imperial dynamics.As demand for industrial laborers increased, it also led to massive migrations of men to expanding urban centers in Southern Africa, indirectly affecting fertility rates and prompting concerns that colonial rule was eroding rather than bolstering population levels .A physician touring the Belgian Congo in the 1920s surmised that “the principal cause of depopulation in the Congo is the European penetration itself.” Referring to rising levels of disease, infertility, and border-crossings, he continued: “since all of these causes [of ill health] increase more and more as the economic, commercial and industrial development of the Colony increases, the depopulation becomes equally more and more threatening” .The Germans and French focused on developing drug treatments, some of which were arsenic-based and near-deadly in effective dosages [6, 8], while the British often chose to cordon off affected groups, using coercive tactics and forcing large numbers of people to leave their villages .Both methods—drug treatment and forced removal—ultimately stemmed the Lake Victoria epidemic, although questions about its causes lingered as did the endemic foci of the disease [6, 8].