The history of sleeping sickness (human African trypanosomiasis) in colonial Africa has received intense scholarly attention in recent years. Studies have scrutinized the colonial anxieties and disease control strategies that epidemic sleeping sickness triggered in large parts of West, Central, and East Africa from the late nineteenth century onwards, as well as, more recently, the transimperial flows of experts, knowledge, and practices that the disease helped to produce. Mari K. Webel builds on, but also clearly departs from, this rich and still expanding scholarship, as she adopts a distinctly Africanist perspective that focuses on how Africans made sense of sleeping sickness and engaged with colonial campaigns against it.
Webel tackles these questions by studying three Eastern African societies that were heavily affected by epidemic sleeping sickness in the early twentieth century: the Ssese Islands in the Buganda kingdom on the British-ruled shores of Lake Victoria (Chapters One and Two), the Haya kingdom of Kiziba further south on the German side of the lake (Chapters Three and Four), and the southern Imbo region on the German side of Lake Tanganyika (Chapter Five). These case studies were not chosen at random: they cover the places where German doctors, starting with Robert Koch on the Ssese Islands, established the practice of sleeping sickness isolation, in what they called ‘isolation camps’ or sometimes also ‘concentration camps’, as a key element of their anti-sleeping sickness campaigns (105). The result of Webel's ingenious research design is a dense, detailed, and locally embedded yet strongly argument-driven study. It weaves local societies’ dealings with sleeping sickness together with the history of the sleeping sickness camps during German colonial rule in East Africa. Building mainly on German colonial and missionary sources, most notably from the White Fathers, the book offers two major interlocking arguments.
The first main argument is that local societies’ understandings of and engagements with epidemic sleeping sickness were moulded by the particular social context in which the disease took root, as well as by changing local cosmologies and illness management practices. Ssese Islanders, the inhabitants of Kiziba, and the Bwari and Rundi in southern Imbo had different terms for, and shifting definitions of, sleeping sickness — which may have existed previously, but probably not in epidemic form. But these peoples all interpreted the disease, which they referred to as mongota, isimagira, or malali, against the background of previous epidemics, which were probably cholera, bubonic plague, and smallpox. In responding to sleeping sickness, people thus drew upon and expanded the disease-coping strategies that had been deployed during these other epidemics, such as the practice of isolating the sick (Chapters One, Three, and Five).
These local understandings and disease-coping practices, as the second argument posits, also shaped the trajectory of German colonial sleeping sickness efforts in East Africa, in particular that of the sleeping sickness camp (Chapters Two, Four, and Five). According to Webel, the thousands of Africans who initially sought biomedical treatment in the German sleeping sickness camps on the Ssese Islands and in Kiziba were not enticed by the scientific rationality of the camp regime and its painful atoxyl injections, as German doctors liked to think. They were rather attracted by the particular location of the camps at sites of important spiritual power and royal authority, as well as places with histories of missionary healing activities. These meaningful emplacements made them particularly suitable sites to test new therapeutic practices. Some people also wanted to benefit from the extramedical advantages offered by the camps, such as plots of land, food, and even cash.
For Kiziba, Webel aptly shows that approval also fluctuated with the Ziba king's authority and active support for colonial public health measures. Here, the camp doctors at Kigarama employed young Ziba men dispatched by the king to detect potential cases of sleeping sickness. They canvassed the region and examined people's cervical glands, which were often swollen in cases of infection. People increasingly began to flee from these invasive gland-feelers and from the camp, sometimes across the border to Uganda, which not only reflected peoples’ diminishing faith in German biomedical treatments. It was also, Webel argues, a critique of the king's authority, his healing capacity, and his willingness to cooperate with colonial authorities. Ziba people's actions eventually induced the king to reduce his cooperation, while the camp doctors stopped employing gland-feelers and transformed the camp into a polyclinic.
By shifting the focus from European to African understandings of disease, Webel reveals how colonial public health campaigns were embedded in social, ecological, and political dynamics. Her focus on local engagements also has a flipside, however. By reinterpreting the sleeping sickness camp from the contingent perspectives of East African societies, Webel adds a crucial interpretative layer to it, yet disconnects her story from the longer genealogy and broader use of isolation measures and ‘concentration camps’ in both colonial and noncolonial settings. Her approach does not explain why these camps indeed became a ‘portable model’ throughout colonial Africa (88). It also remains unclear what, if anything, was distinctly German about the sleeping sickness camps and the use of atoxyl, the main drug used to treat the disease prior to the 1920s, given the continent-wide employment of both measures. Nor does Webel specify what was distinctly East African about the processes she describes, given similar shifts in Africans’ acceptance of similar treatment regimes elsewhere. Finally, it is a pity that, probably due to the absence of sources, the book provides little concrete information about the therapeutic practices and medicines of diviners, herbalists, and other African healers against sleeping sickness. However, the reader gains a good sense of what those practices and medicines might have been from their dealings with other (epidemic) diseases.
This critique notwithstanding, Webel offers a fascinating and pathbreaking study of how local societies around Lake Victoria and Lake Tanganyika made sense of sleeping sickness and shaped colonial interventions to control the disease. The book is well-written, deeply researched, and persuasively argued. Demonstrating how Africans’ therapeutic resources shifted under the weight of early colonial epidemics and the actions of missionary and colonial agents, this book is not only of interest to sleeping sickness specialists, but essential reading for all scholars of medical history of precolonial and colonial Africa.
