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From ‘Death Camps’ to Cordon Sanitaire: The Development of Sleeping Sickness Policy in the Uele District of the Belgian Congo, 1903–19141
Published online by Cambridge University Press: 22 January 2009
Summary
When sleeping sickness was discovered to be epidemic in the Congo Free State in 1904, the administration responded by attempting to implement public health measures which had evolved in Europe in relation to plague and cholera epidemics. These measures were to identify and isolate victims and suspected victims of the disease and to map out the infected and uninfected zones. This article describes the early sleeping-sickness campaign of the Belgian authorities in the Uele District of Province Orientale between 1904 and 1914, focusing on the formation of isolation camps or lazarets. Uele district had been identified as a potentially rich and uninfected zone to be protected from contamination by the establishment of a cordon sanitaire. Public health policy and practice during this period provides an example of attempted ‘social engineering’ on the part of a colonial authority. While sleeping sickness provided the major impetus for the gradual development of the colonial medical service by the 1920s, the early period between 1903 and World War I was particularly onerous for the African populations in the north-east. The public health policy was perceived by many Africans as one more element in the on-going conquest and exploitation of the region. Examples are provided to demonstrate the ways in which numerous sleeping-sickness regulations affected African societies in Uele.
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References
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6 I would like to acknowledge those who commented on my paper presented to the Society for the Social History of Medicine day conference in association with the African Studies Association of the United Kingdom, ‘The state and epidemics in Africa’, 3 Dec. 1983 in London.
7 I shall employ the name ‘Congo State’ for the period 1885–1908 and the name ‘Congo’ for 1908–1960.
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20 MAEAA 849.273, Texte pour une brochure à l'occasion de l'Exposition de Londres, pour Secrétariat Général, I April 1911, 7. Fishing created many problems for the sleeping sickness campaign. Theoretically, Africans were forbidden to fish tsetse-infested rivers, but generally this prohibition, implemented by destruction of canoes, was very difficult to enforce and it presented grave economic difficulties. Where fishing was effectively restricted, there were serious ramifications for African diets.
21 MAEAA 843.53, Dr Boigelet, 23 Nov. 1911 and 855.25, Vice-Governor-general to Minister, 17 Jan. 1912; Burrows, Guy, The Land of the Pigmies (London, 1898), 55.Google Scholar
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23 MAEAA 855, Prosecutor Nève to Judicial Police, 5 Sept. 1913, regarding a charge against the Africans in the service of a trader at Ango.
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25 Bozas, 399. In the Lado-Uele region in 1902, forty-four out of one hundred European agents died. Sudan Intelligence Report no. 132 (July 1905), reported sixteen out of sixty-three Belgian agents dead, mainly of illness, in the Enclave.
26 MAEAA, 843.46, District Commissioner Bertrand, 17 Jan, 1911.
27 C. Christy, Notebook I (1903–1904), R.C.S. There was still much ignorance of the aetiology of the disease, especially about the connexion of the advanced or ‘sleeping’ stage with earlier symptoms. Christy reported that many people were said to have sleeping sickness but he had not diagnosed one case by 13 Nov. 1903 and he believed that missionaries came to the Congo ‘with all sorts of ideas about all Negro sickness’.
28 Wellcome Institute for the History of Medicine, Library manuscript collections (hereafter Wellcome MSS) 2262, J. E. Dutton, Expedition Diary I, 25 Sept. 1903; J. E. Dutton and J. L. Todd, ‘The distribution and spread of sleeping sickness in the Congo Free State with suggestions on prophylaxis: Fourth Progress Report’, 17 Oct. 1905 (hereafter ‘Fourth’). Dutton and Todd believed that most recent figures of deaths in the Congo and Uganda only approximated the truth because about 30–50 per cent of the population in many villages along the route had trypanosomes and only a small number could be expected to recover. Therefore, one-third of the population would probably die.
29 Sleeping sickness had been reported at Basoko 1889–1891; Ibembo 1894; Van Kerckhovenville 1902; Loka 1904. Dutton and Todd, map IV, ‘The advance of sleeping sickness in the Congo Free State’; Dutton and Todd, ‘Third progress report from the expedition to the Congo, 1903–1904–1905, of the Liverpool School of Tropical Medicine’.
30 Wellcome MSS 2262, Expedition Diary 1, 4 Sept. 1903 and 23 June 1904; Wellcome MSS 2268, John E. Dutton, Expedition Diary 11, 2 July 1904; Wellcome MSS 4796, J. L. Todd, Expedition Diary III, 13 May 1905 to 29 Aug. 1905; C. Christy, Notebook I. At Barumbu agricultural post, for instance, there were 450 Africans on three-year contracts plus 120 local natives and innumerable women on weekly contracts. At Yalekambi agricultural post, women had been brought from far-off Nyangwe. At Basoko prison the team examined seventy prisoners.
31 Cholera epidemics in Belgium spanned the nineteenth century between 1832 and 1892–3.
32 Worboys, ‘Science and British colonial imperialism’. The author suggests that by describing problems in the colonial context as ‘technical’ rather than ‘structural’, the administration could rationalize making adjustments to their policies rather than admit the deeper socio-economic problems. In this way, they could justify simply transferring to Africa their European-derived ideology and technology.
33 Palmberg, Albert, A Treatise on Public Health and its Application in Different European Countries (London, 1893), 255Google Scholar; Kuborn, Dr Hyac, Aperçu Historique sur l'Hygiéne Publique en Belgique depuis 1830 (Brussels, 1897), 213.Google Scholar
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35 Lt Boyd Alexander, Diary 20 April to 18 November 1906, Rhodes House, Oxford. (On 7 June 1906, Alexander was not allowed by the Belgians to go from Niangara to Van Kerkhovenville as it was too ‘unsettled’.) Bozas, 423, discusses the chaos caused by the Babwa rebellions of 1900–1901. See also Fetter, Bruce, Colonial Rule and Regional Imbalance in Central Africa (Boulder, Colorado, 1983), 138Google Scholar; Armstrong Report, FO 367.259/2447; Bakonzi, ‘Gold Mines’.
36 Dutton and Todd, ‘Fourth progress report’, 27.
37 Ford, John, ‘Ideas which have influenced attempts to solve the problem of African trypanosomiasis’, Social Science and Medicine, 13b (Oxford, 1979), 271.Google Scholar
38 Dutton and Todd, ‘Third progress report’, 29–30.
39 MAEAA, H846.9, Dr Low, Royal Society, London, to Secretary of State, Brussels, 20 Jan. 1903. He advised the State authorities that based upon his experience in Uganda they should isolate victims, and that plans were under way in Uganda for the same. MAEAA, H 846.18, Secretary of State to the Governor-general, Boma, 22 Feb. 1903, gave orders to isolate and referred to his letter of 14 Jan. 1903 in which he forbade all travel inside infected areas.
40 The earliest known diagnostic method was the palpation of visibly enlarged cervical glands at the back of the neck. This syndrome was first described by Thomas Winterbottom in 1803 in West Africa in relation to the ‘African lethargy’; hence it became known as ‘Winterbottom's sign’. Even in the early Congo there was considerable debate about the precision of this method. Dr R. Dumont reported in 1934 that palpation furnished a 50–60 per cent error rate and that no doctor would have dared diagnose a European so hastily. (R. Dumont, ‘Le conflit des conceptions médicales au Congo’, Bruxelles, Oct. 1934 (offprint).)
41 Baker, J. R., ‘Epidemiology of African sleeping sickness’, in Trypanosomiasis and Leishmaniasis with Special Reference to Chaga's Disease (London, 1974)Google Scholar, Ciba Foundation Symposium 20. The key to understanding Gambian sleeping sickness is its chronicity. Baker points out that it can be maintained only in areas where man–fly contact is close and repeated, and that it is a ‘peridomestic’ disease.
42 MAEAA, ‘Fourth Progress Report’ of Dutton and Todd, 36; MAEAA 847.143, Dr Dutton to Dr Van Campenhout, 23 April 1906.
43 Rodhain, Dr A., ‘Documents pour servir à l'histoire de la maladie du sommeil au Congo Beige’, Bulletin de l'Institut Royal du Congo Beige (Brussels, 1948).Google Scholar The Government recruited numerous soldiers in Uele to serve outside their territories for seven years.
44 Wellcome MSS 4801. Review of F. O. Stohr.
45 Wellcome MSS 4801. Todd noted thirty-six steamers on the Upper Congo in 1903–1905.
46 Wellcome MSS 2268, 16 Mar. 1903 and MAEAA 846. 20 of 5 May 1903.
47 MAEAA 846. 22, 5 May 1903, Vice-Governor-general to all territorial administrators, doctors and commanders. A decree of 22 Aug. 1888 made notification of infectious diseases obligatory (B.O., 11 Nov. 1888).
48 Wellcome MSS 2262, 30 July 1903. MAEAA 846.40, Chef de Zone (Makraka) to Governor-general, 10 July 1903.
49 Dutton and Todd, ‘First Report’, 186–188; and ‘Fourth Report’. Both the Zande and Babwa of Uele practise isolation; the latter generally send an individual to a maternal uncle in order to remove him from the possibility of evil intention which could be causing illness. (Mboli André (Zande-Avungura) and Ngbato Gilbert (Babwa), interview at Tongerloo, Prémontré Abbey, Belgium on 20 and 21 Aug. 1982.)
50 MRAC 58.20.54, Dr Rodhain. On 3 June 1906 King Léopoid decreed a prize of 200,000 francs to anyone who discovered a cure and he established a credit of 300,000 francs for research (B.O., 1906).
51 Lazarets were Nouvelle Anvers, Lusambo, Stanleyville, Léopoldville, Ibembo and Pania-Mutombo, while Yakoma and Uvira were observation posts only.
52 MAEAA 843.53, Dr Boigelet's report, 6 Feb. 1912, noted that Africans came to Ibembo from Mandundu, Mobwasa and Bumba for palabres; they travelled via Bumba-Bondo to avoid the observation post. Likati people did likewise. MAEAA 848.113, Chef de Zone Millo Ribotti (Rubi) to Governor-general, 15 Oct. 1909, stated that the only Africans under control were the soldiers, who were obliged to carry passes to travel. Natives going between villages were completely uncontrolled. This included the rubber collectors coming into the southern part of his zone and to the Bomokandi River in very numerous caravans, who stayed for fifteen days.
53 MAEAA 838.23, Dr Grossule, Basoko Report, 1906.
54 MAEAA 847.257, Dr Hosselet, Lado Enclave, I Nov. 1906.
55 Dr, Emile Van Campenhout et al. , Interim Report on TB and Sleeping Sickness in Equatorial Africa (League of Nations, 1923)Google Scholar; Trolli, Dr G., Exposé de la Législation Sanitaire du Congo Belge (Brussels, 1938).Google Scholar In 1908 there were 30 State doctors and in 1914 there were 81.
56 MAEAA R/CB No. 3 (149) Goidtsnoven, Dr Van, M.M.S.U. Report for 1922, April 1923.Google Scholar As late as 1922 there were reports that the missions still avoided involvement because there were no ‘impressive’ cures as with yaws. One State doctor reported that ‘From the point of view of recruiting Christians, sleeping sickness work is harmful’ (MAEAA R/CB 149/4, Dr Mouchet's annual report, 1923). He said the missions were not co-operating as they were afraid to ‘offend the Africans’. In fact many missions made significant contributions to the sleeping sickness campaign, especially after 1910 when officially requested to do so by the administration.
57 MAEAA 846.1, Dr Rossignon to Governor-general, 24 Oct. 1902.
58 MAEAA 843.20, Dr Heiberg Report on Ibembo lazaret, 14 Feb. 1910. Dr E. Van Campenhout's May 1923 Report to the League of Nations, 63, said the early lazaret policy in Congo had been harmful because ‘Compulsory isolation, imposed as a military measure, proved disastrous. The natives ran away, avoided the visits, lay hid… the fear of the medical officer and his needle was such that entire villages fled’.
59 There are sufficient sources for Ibembo lazaret in both the MRAC and MAEAA, including several registers.
60 Wellcome MSS 2268, 15 July 1904. Ibembo training camp took in 1,200 Africans and dependants every eight to twelve months and most of the internees at Ibembo lazaret were from the army or State employment.
61 MAEAA 843.20, DrHeiberg, , ‘Rapport et propositions de Lazaret d'Ibembo’, 14 Feb. 1910, 14 pp.Google Scholar
62 ibid.
63 ibid.
64 MAEAA 842.26, Secretary of State to Governor-general, 9 June 1908.'
65 MAEAA 843.3, Secretary of State to Governor-general, 11 Nov. 1907.
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75 ibid.
76 ibid.
77 MAEAA 842.88, Minister Renkin to Governor-general, 7 Dec. 1910, refers to letters of 17 and 31 Jan. 1910 in which it was pointed out how important it was to the government to construct new lazarets. The king had allocated 600,000 francs in 1910, plus a new credit in 1911, for that purpose.
78 MAEAA 848.114, Minister to Governor-general, 17 Jan. 1910; MAEAA 831, ‘New sleeping sickness measures’, 10 June 1910.Google Scholar
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80 MAEAA 849.206, Fuchs Circular; 855.30 April 1910; MAEAA 859.14, Vice Governor-general to territorial chiefs and doctors, 30 April 1910; Christy, C., ‘Final Report’Google Scholar, RCS.
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83 MRAC 58.20.55, Dr Rodhain, 15 Dec. 1915, and MAEAA 4403.435, Governor-general to Minister, 16 Feb. 1914.
84 MAEAA 849.331, ‘Réglement coordonnant les mesures prises pour enrayer la Maladie du sommeil’, 22 July 1912.Google Scholar
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87 Le Mouvement Géographique, no. 22, 18 Sept. 1892.
88 Foran, Major William, ‘Ivory Poachers of the Lado Enclave (1902–1912)’, unpublished MSS, Rhodes House, OxfordGoogle Scholar; MAEAA 855.55, 4 July 1913, Dr Rodhain, ‘Premier rapport préliminaire sur la maladie du sommeil dans le district de l'Uele’.
89 Ordinance of 9 Sept. 1910. This formally established the ‘triangle’.
90 MAEAA 855. 18, Commissioner General Bertrand to Governor-general, 22 May 1911.
91 Armstrong, ‘Report’, 21 Jan. 1911. P.R.O.: FO 367/259/2447.
92 MAEAA 847.317, Dr Heiberg to District Commissioner Gilson, Uele-Lado, 20 May 1907.
93 MAEAA 855. 1, Dr Paul Errera, director of Aba lazaret to General Commissioner: ‘Ill and abandoned porters are left to the mercy of local chiefs and I found four such at Dondoro's who had been left behind two years before’. He sent them to Ibembo.
94 MRAC 58.20.55, Rodhain, Dr, ‘Rapport’, 15 Mar. 1915.Google Scholar
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96 MRAC 50.30.84, 17 July 1919. District Commissioner A. Landeghem to sector chief, Likati: ‘All canoe traffic, European or African, is forbidden by day on the Likati River’.
97 MRAC 50.30.144, 17 July 1914, Directeur du S.R. to District Commissioner, Buta.
98 MRAC 50.30.374, 5 Oct. 1916, Territorial agent, Dakwa, to District Commissioner, Buta.
99 In 1912 the District of Uele was divided into two administrative districts: Haut and Bas-Uele.
100 MRAC 50.30.292, Prosecutor Nève to District Commissioner, Buta, 7 May 1914.
101 Article by McLaren, J. C. in Western Daily Mercury, 7 Mar. 1907.Google Scholar McLaren was a representative of the East Africa Trading Company who travelled across Uele. He reported that he was told repeatedly by post administrators that they were constantly ‘dunned’ by correspondence from headquarters if the rubber and ivory were not forthcoming in quantities.
102 MAEAA 841.11, Rapport Sanitaire, 20 Dec. 1910.
103 MRAC 50.30.374/55, D.C. Gwane, 19 July 1916.
104 MAEAA 850, Governor-general to Minister, 2 Nov. 1918.
105 Bakonzi, ‘Gold Mines’, 148–149, 154. An August 1910 decree limited the power of State officials to refuse travel permits to Africans employed by the State or the mines. Thus before 1916 Kilo-Moto could obtain labour from rural areas. Between 1905 and 1919, State agents recruited labourers for the mines which were, in effect, a colonial department. By 1919, Moto had thirty-two camps with 6,851 African labourers and Kilo had thirteen with 7,000 men.
106 MRAC 50.30.46, D.C. Acerbi to D.C. Buta, 14 Dec. 1914.
107 MAEAA 855.67, Rodhain, ‘Fourth Report of Sleeping Sickness Mission to Uele', 1914.
108 MAEAA 843.46, Dr Bottalico, First Semester Report, 1910, Ibembo Lazaret.
109 Evans-Pritchard, E. E., Witchcraft, Oracles and Magic among the Azande (Oxford, 1937), 260, 271.Google Scholar
110 MRAC 50. 30. 44, Chef de Zone (Rubi) Landeghem, ‘Monthly Report’, Oct. 1908; MRAC 50. 30. 2 Chef de Poste (Zobia), ‘Monthly Report’, 29 Feb. 1912.
111 Christy, C., ‘Final Report to Sudan Sleeping Sickness Commission’, 1916Google Scholar, RCS.
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