Medicine, empires, and ethics in colonial Africa

This essay examines the history of European empire building and health work in sub-Saharan Africa, focusing on four patterns that shed light on the ethics of outside interventions: (1) the epidemiological and bodily harms caused by conquest and economic development; (2) the uneven and inadequate health infrastructures established during the colonial era, including certain iatrogenic consequences; (3) the ethical ambiguities and transgressions of colonial research and treatment campaigns; and (4) the concerted and inadvertent efforts to undermine African healing practices, which were not always commensurable with introduced medical techniques. This kind of historical analysis helps us home in on different kinds of ethical problems that have grown out of past asymmetries of power-between people, professions, states, and institutions-that shape the nature of international health systems to this day.