Historicizing participation and avoidance of health interventions: Lessons from colonial East-African sleeping sickness campaigns

Diverse factors shape community participation in a public health intervention.  How can knowledge of a community’s history deepen our understandings of how and why people avail themselves of one treatment and not another?  What non-medical experiences and considerations influence whether engagements with public health campaigns?  Histories of colonial anti-sleeping sickness campaigns in Africa’s Great Lakes region indicate that the political economy of land and labor in the region’s kingdoms played a central role in the campaign’s fortunes in the early twentieth century.  Focusing on a set of sleeping sickness camps led by German colonial officials, this paper discusses how pre-existing political relationships and economic concerns shaped both how colonial authorities incentivized participation from people they wished to attract as patients, and how people used campaign resources to improve their circumstances.  Past experiences with matters as diverse as bubonic plague, coffee cultivation, clanship, and royal succession controversies influenced the creation of sleeping sickness camps and their meaning once in place.  Layered upon these histories were the impacts of ineffective drug treatments, the lure of expanding agricultural cultivation, and the unpredictable impact of a cohort of local medical auxiliaries.  Occurring simultaneous with political and social change, colonial sleeping sickness interventions became a field upon which African and European actors negotiated matters mundane and extraordinary.