Public health, the native medical service, and the colonial administration in French West Africa, 1900-1944

From 1900 to 1944, public health was a pillar of the French colonial project in French West Africa. African medical workers became the backbone of the Native Medical Service, which sought to “grow the race” (faire du noir) and popularize French cultural ideals while improving the general health of the African population and combating epidemic diseases. Through successive yellow fever and plague epidemics, the Medical Service honed a set of health measures that it utilized in epidemic outbreaks. These health measures remained largely unchanged throughout the period. The political environment and the reactions of African residents, especially residents of the Four Communes, to these anti-epidemic measures did change though. Intermittent popular resistance to health measures, along with persistent personnel shortages, budget constraints, the sparsely settled population, and the vast land area of West Africa conspired to make the goals of the Native Medical Service difficult to achieve. An examination of the internal profile (personnel numbers, job descriptions, evaluations, organization and organizational changes, and policies) of the Native Medical Service from 1900 - 1944 demonstrates some of the aspects of how the ideology of French colonialism was at odds with itself and with colonial realities. The Native Medical Service was an arm of the colonial government in areas where it was weak, such as spreading French civilization and appreciation for French culture. Despite being used to compensate for some of the government’s shortcomings, the Native Medical Service experienced disjunctions between its goals and the means to achieve them that hindered its effectiveness. The ideological core of French colonialism was built around the Civilizing Mission, development (la mise en valeur), and the myth of the indissolubility of Greater France. The widespread French belief in African inferiority and that the benefits of French imperial rule to the subject peoples outweighed the drawbacks both worked against the success of French goals in West Africa to spread their civilization, foster economic and human development, and form a lasting addition to France Outre-Mer.