In 1904, sleeping sickness was declared to be epidemic in some parts of the Congo Free State. This was the conclusion of a team of British scientists invited from the Liverpool School of Tropical Medicine to conduct a survey of health conditions in central Africa. They advised the state authorities to take immediate action to control the further spread of sleeping sickness. It was certainly not the first time the disease had been reported. The ‘sleepy sickness’ had been noted in the region in the early 1880s, and fresh outbreaks were confirmed by missionaries and travellers. But, by 1901, a terrible epidemic had spread around the northern shores of Lake Victoria and neighbouring islands in the Lake in the region of Busoga, in the adjoining Uganda Protectorate.

The declaration of an epidemic was a watershed in the history of public health for Africans in the Congo; for, more than any other one factor, sleeping sickness prompted the development of the Belgian colonial medical service. This medical service was consciously used by the Belgians as a form of ‘constructive imperialism’, with which they hoped to establish European influence. The provision of health services was considered by the Belgians to be a central feature of what they called their ‘civilising mission’ in Africa.

In discussing sleeping sickness in Africa in the early twentieth century, there are three important points. First, there was a direct link between sleeping sickness and the rapidly expanding new field of tropical medicine.