Practising Colonial Medicine: The Colonial Medical Serice in British East Africa

For today's students of Africa, Colonial Service personnel are a distant generation with very different world-views. Why would one have become a medical officer in the service of empire? This question is addressed in different ways in these two books that deal with the practice of medicine in East Africa. They belong to different genres - one academic, the other a personal account written after a lifetime's commitment to public health - and they cover different historical periods. Despite these differences, the books provide complementary reading, because they occupy themselves - one explicitly, the other implicitly - with the identity, culture, ethos and lifestyle of a part of the Colonial Service.

Crozier's book focuses on the early decades of the 20th century. Based on official sources and documentary evidence, the author explores recruitment for the Colonial Medical Service in Africa, aiming to discern the values underlying selection processes, and, more broadly, the ideology and identity of the medical corps. Who were the colonial doctors? She reveals a strong concern with Britishness and empire, and with class and race, as well as attraction to a certain middle-class lifestyle and freedom. One gets the impression of an overall conservative group. This is somewhat surprising as one would have imagined that medical people also embraced a progressive scientific ethos - which Crozier only briefly touches upon. 'Britishness' and the ideals of Empire doubtlessly are somewhat 'conservative' from today's vantage point. Yet the imperial project was, especially towards the end of the period covered by this study - when colonial governments increasingly focused on welfare and development - thoroughly 'modern'. Doctors and other scientists can be said to have been the vanguard of this expansive modernity (irrespective of whether their attitudes and values would be fashionable today). Therefore, the tensions between traditional social values and the progressive ethos of medical science and of the colonial governmental welfare project would have been worth looking at in more detail. Along the same lines, it would have been interesting to explore further the tensions between different viewpoints, at the time, such as between the doctors' own understanding of their task, and the perspective of other colonial actors in the administration and the settler communities. Such an analysis might have depicted the medical men as rather more progressive - in the terms of their day - and more diverse in terms of ambitions and background.

Diversity and conflict could also have been explored in and around the relationships between British doctors and Africans. The near absence of Africans - whether as medical staff or as patients - from this account of medicine in Africa is a shortcoming, not just because of post-colonial political correctness, but because greater attentiveness to the interactions between different actors would have allowed us to see in a clearer light the doctors to whom this study is dedicated. Part of the problem lies in the limited documentary basis. The limitation on written materials makes it difficult to elucidate 'identity and experience', or 'culture' - which are stated aims of the book - and one is left wondering why the personal accounts of doctors and their oral histories (some are still alive!) have not been utilised. Had the author drawn on a wider range of sources, one might have been able to see the greater diversity among the doctors, and the tensions and conflicts as well as bonds and mutual commitments, among the British protagonists and their African colleagues and patients. Overall, however, the book covers an important and under-researched dimension of the medical services in Africa - recruitment to the service. It thus provides evidence of who was recruited before the war, and how recruitment practices changed, and some evidence of why young medical men choose this career. As such, it lays a solid foundation to further investigations into the social life of medicine in East Africa.

By way of conclusion, this book when combined with Spindoctor can be warmly recommended to readers interested in the history of medicine and the Colonial Service, as well as in the colonial project as such. Crozier provides us with useful facts and figures on recruitment and the background of pre-war medical staff, and triggers many questions that will inspire future research. Rickman in Spindoctor provides for somewhat lighter reading, but the wealth of detail of his account speaks very well to recent scholarly interests - in the social science and humanities and in public health - and goes thus far beyond what one would expect from a medical biography. It provides a good read to all of us, but it should not be overlooked by the academic readership.