Africa and Medicine

When did David Livingstone's medicine cabinet for would-be tropical travellers go on sale?
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Who marketed David Livingstone's travelling medicine cabinet?
An early pharmaceutical company in London
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What were Livingstone's Rousers?
A miracle cure for malaria, pills made based on Livingstone's own recipe
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Did Livingstone know about the mosquito borne parasite?
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Did European society know that quinine alleviated symptoms of malaria?
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When was quinine 'discovered' by Europeans?
In the 1820s by Portuguese Jesuit missionaries
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What did Livingstone and his contemporaries think caused malaria?
Breathing in bad air in swampy areas
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How was quinine useful in the conquest of Africa?
Allowed to travel further into the interior.
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In the early 19th century what did Europeans believe caused illness?
Disorders in the blood, intestinal system. A lack of balance as a result of excess/deficiency
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Was the theory of humours still in use in the early 19th century?
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In the early 19th century what were bodily functions believed to be affected by?
Moral disposition
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What does Etherington say about missionaries?
"The settler and the mining magnate merely wanted the Africans' land and labour. Missionaries wanted their souls."
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In what ways did missionaries intervene in everyday life that early colonial state did not?
Education and healthcare
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What was the interest of the early colonial state?
Establishing authority
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What did the early colonial state need from Africans?
Translators and a healthy workforce
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Who often ran the education paid for by early colonial governments?
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By what decade were governments also concerned about the health of urban workers?
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How does Fred Cooper describe the resources distribution of the colonial state?
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What was an issue associated with missionary edcuation?
Opened up new division between the educated and uneducated within African societies
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Why did African people want to be educated?
Aware that education opened up jobs
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What do historians argue over?
Whether missionary schools were the ultimate display of how colonial imperialism controlled ways of living OR if they were beneficial as allowed Africans to work towards independence
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What must be remembered about colonial power?
Did not lead to just political change
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What were missionaries important enactors of?
Cultural change
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What did colonialism bring to Africa?
Drastically altered ecologies, new contagious diseases and moved populations from healthy to unhealthy locations
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What were European medical ideas in the early 19th century based on?
Understandings of bodies in imbalance, centred on blood and digestion
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What had arrived by the end of the nineteenth century?
The beginning of medical ideas which are more familiar, such as gene theory and biomedicine
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Several early missionary doctors such as David Livingstone were quite keen to learn about what?
African ideas of medicine
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What was a negative part of the history of biomedicine?
The way it shut itself off from other healing systems and over time saw African healing systems as separate and primitive
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By the end of the 19th century there was a dismissive attitude among medical doctors towards what?
African methods
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What do Hartwig and Paterson (1878) see as "undoubtedly" the unhealthiest period of African history?
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What must be remembered about the unhealthiest period of African history?
Not to say colonialism is to blame or that Europeans meant to bring disease - it is not about blame but understanding
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What is trypanosomiasis?
Sleeping sickness
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Which group of Africans had known about sleeping sickness for a long time?
West Africans
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How many people is it estimated were killed in sleeping sickness epidemic from 1860s onwards?
One million
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A sleeping sickness epidemic begun in West Africa in 1860s. It spread through central Africa. What year did it reach Northern Rhodesia by?
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What do many historians argue regarding European involvement in sleeping sickness epidemic?
European ignorance of balance of African communities with environment disrupted methods that had prevented spread of disease
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What worsened the spread of sleeping sickness?
Mfecane Wars and slave trade
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What spreads sleeping sickness?
Tsetse fly
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Where is tsetse fly and animals it lived on from?
Bush areas
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What did farmers do to protect from tsetse fly?
Cut down bushes and live save distance away with complicated zoning
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What was the pathway of zonings regarding the tsetse fly?
Wild animals - livestock - people
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Did Europeans know about the zoning practice with regards to the tsetse fly?
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How did the colonial administration worsen the situation regarding the tsetse fly?
Took everyone as far away from the bush as possible which allowed bush to incubate and disease to spread further afield
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What disease worsened the effect of sleeping sickness?
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What was rinderpest?
Cattle disease
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How did rinderpest worsen sleeping sickness issue?
Upset the balance of farming systems that had been helping to keep the tsetse fly at bay
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Who brought rinderpest to the Horn of Africa?
Possibly the Italians or British who had imported cattle to feed troops.
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What percentage of cattle could rinderpest destroy?
Up to 90% in some instances
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In which communities was rinderpest particularly devastating?
Where coincided with European settlement
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Where did smallpox occur?
Areas also affected by drought beginning in 1880s and lasting until 1920s
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Why did colonial governments order compulsory purchasing of food?
Feed troops
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When was there famine in East Africa?
1880s and 1890s
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When was there famine in West Africa?
1913 to 1914
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When was there famine in French equatorial Africa?
From 1918 to the mid 1920s
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What was the biggest killer disease?
Spanish Influenza
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In most African colonies what percentage of the population were killed by Spanish Influenza?
Between 2% and 5%
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How did smallpox often spread?
Along the new colonial transport links that had just been built
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What created new and unhealthy environments which people lived in?
Mining industry in particular
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According to Megan Vaughan (1991), in British colonial Africa, what did medicine and associated disciplines help create?
Construction of 'the African' as object of knowledge which was "intrinsic to the operation of colonial power"
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How could medical encounters sometimes breach the distinctions between people that colonialism tried to reinforce?
Often involved quite intimate contact between men and women and white and black people.
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What concerned Chief Makaba when Robert Moffat talked to him about Jesus in 1842?
"I do not want to hear again about the dead rising! I have slain many thousands, and shall they arise?
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What do Joan and Jean Comaroff see as the essence of colonialism?
"inheres less in political overrule than in seizing and transforming 'others'... interacting with them on terms not of their choosing
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What does Kirk Arden Hope see British sleeping sickness control in colonial Uganda and Tanzania as?
"a powerful mechanism for environmental and social engineering"
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How many people were killed by the sleeping sickness outbreak in Uganda at the turn of the 20th century?
250,000 approx
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What led British disease control officials to forcibly depopulate areas infested with tsetse fly and organise African labour to clear vegetation along roads and beaches?
Ugandan sleeping sickness epidemic
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Beginning in the Tanganyika Protectorate after 1920, where did colonial officials concentrate people?
Strategically located new villages, surrounded by depopulated tsetse areas
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In the Tanganyika Protectorate what did colonial officials have Africans do?
Cut and burn large swathes of land as barriers to the spread of the tsetse fly between depopulated and settled land
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What was the consequence of the campaign against sleeping sickness, involving tens of thousands of Africans, that lasted until the end of British colonial rule?
Depopulation of thousands of miles of territory
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In depopulated areas, who were the only people it wasn't illegal to be present?
Colonial scientists and administrators, their African agents
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What was the negative of the depopulation of areas?
Made the land less attractive to future resettlement but very attractive to tsetse as bush filled
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What does Kirk Arden Hope argue that colonial sleeping sickness control shows?
Emerging Western ideas and institutional powers of public health linked to environmental intervention
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In Tanganyika what was the reason for sleeping sickness control?
Was not a response to a particular epidemic but to fears of rapidly expanding tsetse infestations
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Where does Kirk Arden Hope see sleeping sickness control as "central components to the occupation and organization"?
Economically and politically marginal areas
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When did the British assume formal colonial control of Uganda?
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When the British assumed formal colonial control of Uganda, what was happening there?
An epidemic was raging in Busoga
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In Busoga in 1903 what did colonial scientists make a connection between?
Tsetse, protozoan parasites known as trypanosomes and sleeping sickness
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Where in Uganda did medical officials depopulate?
Lake Victoria shore and islands, areas to the north of Buganda, territory often outside direct British and Gandan control
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When did the sleeping sickness epidemic in Uganda abate?
After World War I
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After the sleeping sickness epidemic in Uganda abated, where did the British continental focus of sleeping sickness research go?
The newly acquired British protectorate of Tanganyika
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How does the French journal the 'Tunisian Review' describe doctors at the turn of the twentieth century?
"The doctor is the true conqueror, the peaceful conqueror."
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What is the distribution of sleeping sickness directly linked to?
Range of the tsetse fly
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How many of the 20 species of tsetse live in East Africa?
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What conditions are lethal to tsetse?
Extreme dryness, wetness, heat and cold
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Prior to colonial settlement how did people tend to live?
Scattered settlements
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What were the positives of living in scattered settlements?
Kept bush and sleeping sickness at bay over wide area
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What led people to abandon dispersed habitats?
Heightened levels of insecurity in the age of Mirambo among others - self-defence
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How many people were killed around the northern shore of Lake Victoria in the late nineteenth and early twentieth century?
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According to Richard J. Reid, how many people may have been killed by sleeping sickness in equatorial Africa?
Up to 90% of the population
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What percentage of cattle, buffalo, eland, giraffe, wildebeast etc were killed by rinderpest?
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In South Africa how many cattle were lost due to rinderpestt?
2.5 million
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What was the consequence of the rinderpest epidemic for the Masai tribe in Kenya?
Reduced to starvation
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What was the combined effect of rinderpest and a smallpox epidemic for the Masai in Kenya?
Severely reduced their numbers
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As a result of the reduced numbers of Masai, what happened when colonisers moved into Kenya?
Found great tracts of empty land, probably formerly populated by the Masai
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Did the Masai ever regain their supremacy over the Kikuyu tribe?
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Rinderpest arrived in the pastures of Natal and Zululand in late 1896. What disasters had already befell the area, leading to starvation?
Locust swarms and drought
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What were Natal government authorities worried about in Zulu homesteads?
Incidents of sexual rebellion
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What took precedence - sexual rebellion or rinderpest?
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Why did rinderpest take precedence for the government authorities of Natal in South Africa?
Threatened white owned commercial livestock
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In 1897 in South Africa what did policemen, magistrates and veterinarians set out to do?
Innoculate healthy cattle with a vaccine concocted from bodily matter of cow afflicted with rinderpest
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Who had invented the rinderpest vaccine?
Doctor Robert Koch
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Why was Doctor Robert Koch invited to South Africa?
To immunise agents and assets of European progress?
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Where was one of the places in the world where smallpox was highly endemic?
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In the first half of the twentieth century only which areas exceeded Africa in the number of cases of smallpox?
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What can be seen as justification for the higher number of cases of smallpox in Asia?
India and Pakistan had highly concentrated populations
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In the first years after the World Health Organisation voted to eradicate smallpox what were the number of cases of smallpox in Africa?
In 1959 15,781; 1960 16,127 1961 24,182
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In Europe how many cases of smallpox were there between 1959 and 1961?
89 cases of smallpox
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What was the incidence rate of smallpox in Tanganyika in 1962?
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What was the incidence rate of smallpox in India in 1962?
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Where was the highest incidence rate of smallpox found in 1962?
Congo (Brazza)
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What was the incidence rate of smallpox in Congo (Brazza) in 1962?
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How many countries reported more than 500 cases of smallpox in 1962?
Three Asian countries and fourteen African countries
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For most years between 1928 and 1966 in Africa how many cases of smallpox were there?
Between 15,000 and 30,000 cases
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When was there a sharp increase in smallpox cases?
World War II - large numbers of men mobilised for national service
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By the time that Europeans moved to occupy Africa how much experience of Jenner's improved method of vaccination at home had they?
A century
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By 1900 where had smallpox declined dramatically?
A number of European countries, including all those with colonies in Africa
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Why had smallpox cases declined dramatically in many European countries?
Systematic vaccination and revaccination programmes with glycerated calf-derived vaccine
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What was one of the first and most widely practiced medical interventions in African colonies
Smallpox vaccination
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When did colonial medical services expand?
Between the wars and especially after 1945
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Vaccinations for what disease overshadowed others in terms of the number of people reached?
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1954 health service report for French West Africa listed how many smallpox-yellow fever vaccinations?
Over 3.6 million
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1954 health service report for French West Africa smallpox only vaccinations
1.6 million
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How many yellow fever only vaccinations were there reported in French West Africa in 1954?
87,529 vaccinations
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How many tuberculosis (BCG) vaccinations were there in French West Africa in 1954?
53,994 vaccinations
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What question was often asked in colonial health reports, especially in colonies where smallpox was under control?
Origin of new outbreaks of the disease
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Where did new outbreaks of smallpox often originate?
Imported into the colony from outside
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How could smallpox be imported into colony?
Traditional overland travel patterns (trade + pilgrimage across Sahara) and also new routes by investment in colonial transport, esp.. railways and seaports in early in colonial rule
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What route did the smallpox epidemic of 1913-14 follow?
Dakar-St Louis Senegal railway line
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Where was there a smallpox epidemic in 1909?
new Tanganyika raiwlway line
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Where was there a smallpox epidemic in 1890?
Construction route of Matadi-Stanley Pool Railway in Congo
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Which ports reported smallpox epidemics prior to the First World War?
Dar es Salaam and Zanzibar
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Why was there very significant movement between colonies?
New colonial boundaries cut across populations and trade routes
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Where is smallpox an ancient disease?
Kenya and the rest of Africa
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What does Marc H. Dawson argue about patterns of smallpox transmission?
"patterns of transmission, the rates of endemicity and epidemicity and the measures employed to control the disease changed in the early twentieth century"
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In Kenya what had significant effect on the way smallpox was spread and controlled?
Socioeconomic changes of the colonial period
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What does Marc H. Dawson see as the most important cause of precolonial epidemics?
Social reaction to famine
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What was the effect of the socioeconomic changes in Kenya during the colonial period on smallpox?
Caused the disease to appear more frequently in small local outbreaks with sizeable epidemics becoming more uncommon. Endemicity changed from low rates before 20th C to higher rates during early years of 20th C. Widespread epidemics became infrequent
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What was unusual about the increased movement of epidemic diseases during the early colonial period?
Occurred without famine
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Introduction of cash crops
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Labor Migration
Larger and more frequent population movements
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Larger and denser population
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What was a positive aspect of smallpox vaccination?
Helped prevent vepidemics
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What were the issues associated with the British vaccination campaign in Kenya?
Chronic underfunding, vaccine shortages,ineffective vaccines, local resistance --> local outbreaks frequently although only occasional widespread epidemics
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After the 1897-1900 outbreak, smallpox did not occur in rural central Kenya on an areawide scale until when?
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In rural central Kenya between 1900 and 1912 how do most district and medical reports refer to smallpox occurences?
"sporadic cases" or appearing in "mild form"
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In the precolonial era there was trade and travel to different areas. Give an example.
Some of the precolonial Kikuyu markets were held regularly and attended by over 1,000 people, some of whom travelled great distances to attend
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What were the two groups labour migration had an effect on the epidemiology of smallpox through?
labourers themseles and on the population in reserve
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Several witnesses before the 1912/13 Native Labour Commission in Kenya testified what?
Returning labourers had contracted smallpox while working away from home
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Can instances be found of local smallpox epidemics originating from a returning traveler?
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Prior to what date funding for medical care for Africans was not a high priority in the colonial budget
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Why did many Africans refuse to be vaccinated?
Fear of being poisoned or simply afraid of painful experience
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How did anticolonial movements utilise smallpox vaccinations?
Mumbo cult in Nyanza Province of Kenya from 1913 used vaccination campaigns as vehicle to express discontent
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In the 1940s in Kenya what was the consequence of an inability to deal with smallpox effectively?
Thousands of deaths
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How was Spanish influenza brought to South Africa?
Soldiers returning from WWI - boats arrived in major ports
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How was Spanish influenza described in the Xhosa language?
umbathala - disaster
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From October to November 1918 where in South Africa was ravaged by Spanish Influenza?
Transkei and Ciskei in the rural Eastern Cape
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Surrounding Spanish influenza, when the colonial public health officials brought flu innoculation kits to black reserve what rumours often followed
"long needle" of "white man" came to inject more harm
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The Christian Express reported in late 1918 that Xhosa messengers were doing what? (vaccination)
Warning of a device "to finish off the Native races of South Africa... sending out men with poison to complete the work of extermination"
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What did bacteriologists reccomend?
Mandatory innoculations
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How did black people increasingly view vaccination medical campaigns?
Strategy to boost white supremacy
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In a modern map of public spending on healthcare, what has happened to West Africa?
Almost disappeared
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In Christian worldview of missionaries as well as mindview of many Africans, what was there a link between?
Spiritual healing and medical healing
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Missionaries recede in importance providing healthcare in late colonial and post-colonial period but missionaries from where remain important in modern discourses of HIV/AIDS etc?
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What does Megan Vaughan criticise about Western bio-medicine?
Tends to focus upon individual pathologies and biological reasons for illness rather than social issues
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In Africa biomedicine sought social explanations for natural phenomenons. According to Vaughan what is the significance of this?
May usually think of biomedicine as separate from social and political discourses - shows that is not the case
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According to Fred Cooper how did colonial empires differ from other forms of domination?
"by their effort to reproduce social orcultural difference"
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What was the significance of difference to colonialism (Fred Cooper)?
No matter how conquered learn will never quite get to level of their master
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Ideas regarding Africa began to change in 1920s with 'difference' attributed to culture
Sickness due to deculturation/detribalisation
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What were colonial officials often afraid of?
Social disintegration
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When did women become noticed by colonial offciials?
When realised they did not appear to be able to be controlled by African men - e.g. when start moving to towns in their own right
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What were issues that affected the interwar years?
Low fertility rates and sexual diseases
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How were low fertility rates and sexual diseases viewed by colonial officials and medical doctors?
Not as consequences of poverty and living conditons but as due to immorality and abandonment of tribal/Christian values
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medical pluralism
Argument that African healing systems remained as a viable treatment option
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Did African healing systems survive in isolation from biomedicine?
No, was alongside. Can absorb some of the aspects of practice.
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In Ghana from 1974-1985 how much did public health spending fall?
By 60%
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There was rapid extension of healthcare. Why did it then decline following this?
SAPs and contraction
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In 1965 what was the life expectancy in sub-Saharan Africa?
42 years
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The life expectancy in sub-Saharan Africa increased during 1990s but then fell. What was life expectancy in 2003?
46 years. [Access to biomedicine increasingly dependent on wealth]
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What acts as an alternative framework when the state contracts?
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The number of Africans calling themselves Christian rose from 34 million to 200 million between which years
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Independent churches
Small local churches offering ideas about social healing
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Pentecostal churches
Personal salvation through repentance. Often interested in ideas about globalising modernity. Antagonistic towards African traditions. Links to miionaries.
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Give an example of an Islamist movement that was thriving at the same time as Christianity grew
Muslim Brotherhood in Egypt
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From when did HIV exist in western equatorial Africa?
From at least 1959 (first diagnosis recorded)
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Where was the first urban epidemic of HIV in Africa?
Middle of continent
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Where was first rural epidemic of HIV in Africa?
Border region between Tanzania and Uganda
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When did HIV reach South Africa?
mid-1980s at time of urban unrest and impoerishment
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By 2005 how many people in Africa are estimated to be HIV positive?
Around 25 million people
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By 2005 how many African people are estimated to have died of HIV?
13 million
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By 2005, due to HIV, how many African children are without one or both parents?
12 million children
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What is the issue with the people dying of HIV?
Often middle age at most productive time of life
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How does Megan Vaughan describe the tone of medical discourses on AIDS in Africa, which are often reminiscent of colonial era discourses?
Africans "never get sick innocently"
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What is notable about the first epidemic of HIV in Africa?
Was in a heterosexual population - explains why more contained elsewhere than in Africa
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Factor contributing to spread of HIV - Women
Lower status of women in many badly affected societies, less control over sexual lives
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Factor contributing to spread of HIV - Urbanisation
Rapid and often chaotic urbansatino
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Factor contributing to spread of HIV - Young People
Exceptionally high proportion of young people within African societies
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Factor contributing to spread of HIV - Medical Assistance
Inadequacies of medical assistance, especially by 1990s
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In East Africa especially there are falling rates of HIV. Contributing factors?
Public education campaigns. Preaching sexual abstinence. ARVs reduce chance of mother to child transmission
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What is arguably one of the most important legacies of the colonial history of medicine?
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In South Africa what did the Medicines Act of 1997 say?
Allowed the medicine minister to override health patent laws in a 'health emergency' to get more affordable drugs
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What was the response of global pharmaceutical companies to the Medicines Act?
Court case arguing prices should meet the research and development costs of drugs
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When was the Treatmetn Action Campaign founded by HIV positive activists in South Africa?
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There was a public campaign by TAC. In what year did the pharmaceutical companies withdraw their case and drop the price of anti-retroviral drugs, allowing some to be freely available to African countries?
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Leader of South African government Mbeki at time case denied the link between HIV and AIDS. What else did he do?
Call ARVs toxic and claimed that garlic and lemon juice was more useful. High profile example of mistrust of medical care.
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Treatment Action Campaign had public protests and a constitutional court case, arguing the failure of the South African government to provide ARVs to pregnant mothers at least was unconstitutional. In what year did they win their case?
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In 2003 what did the South African government do?
Rolled out provision of ARVs to all South Africans, not just pregannt mothers
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Other cards in this set

Card 2


Who marketed David Livingstone's travelling medicine cabinet?


An early pharmaceutical company in London

Card 3


What were Livingstone's Rousers?


Preview of the front of card 3

Card 4


Did Livingstone know about the mosquito borne parasite?


Preview of the front of card 4

Card 5


Did European society know that quinine alleviated symptoms of malaria?


Preview of the front of card 5
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