Aickin, David; (2001) From Plantation Medicine to Public Health: The State and Medicine in British Guiana 1838-1914. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

This thesis is about health, medicine, and the state between 1838 and 1914 in the sugar producing colony of British Guiana. Its main theme is the transformation of colonial attitudes towards 'native' health. I argue that at emancipation the government demonstrated little interest in the health of plantation workers or in the health of those who lived in the towns and villages. At this time health provision was primarily a 'private matter' organised by the estate owner or individual. Over the course of the century, this situation changed, beginning with a concern about the health of migrant labour. Later, both government and medical practitioners became deeply interested in the health of the 'people', and in questions of fertility, population, and the problem of infant mortality. I explore what this means by examining the rise of a 'supervisory bureaucracy' and by looking at the political and social conditions of the colony and plantation world. Crucially, I also show that the widening focus for medical provision was not simply the outcome of geographically local or politically internal concerns - but was shaped by wider considerations including ideas of race, civilisation, gender, and not least, by the influence of metropolitan (British) and other imperial political interests. One of the most notable interventions by government was to take away from plantations medical responsibility for estate workers in 1873. Arguably, this marked a profound shift in colonial thinking about the role of the state in organising medical provision. This shift in attitude is further explored by analysing the way in which public health measures in Georgetown, the colony's capital, were developed to deal with infant mortality. There were two specific responses: better midwifery, and cleaner milk. In the chapter on midwifery, I look at how the authorities attempted to alter 'native' midwifery practices. This theme of enculturation is continued in the final chapter on milk. In both cases, I show that Western medicine did not just expand and spread in the colony but was part of a complex process of knowledge dissemination that involved contestation and negotiation.

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