Society, state, and infant welfare: negotiating medical interventions in colonial Tanzania, 1920--1950

Abstract

This dissertation is a historical analysis of colonial state infant welfare initiatives from preventive programs of the 1920s and early 1930s to policies that integrated preventive and curative medicine in the late 1930s and 1940s in colonial Tanzania. It argues that the development of these medical interventions was a negotiated process between colonial government officials, peasants, local chiefs, welfare workers, African dressers, and medical missions. In the 1920s the British colonial government initiated the welfare programs to reduce high infant mortality rates. Government officials explained poor infant survival in terms of maternal ignorance and focused on advising mothers on proper infant care, feeding, and hygiene. The government trained African welfare workers who performed the actual work of advising mothers in the communities. Peasants, however, challenged the early preventive programs as narrowly conceived both because they ignored local medical knowledge and indigenous practices and because they excluded western curative medicine that would help them tackle infant diseases such as malaria. Using their local chiefs, peasants demanded that the colonial government incorporate curative medicine in its welfare policies. Their bargaining strategies to achieve these demands included boycotting government-run welfare centers and refusing to pay taxes. The government eventually incorporated curative medicine in its welfare programs in the late 1930s, and it trained African dressers in preventive and curative medicine. The evidence for this dissertation comes from oral interviews, written archival documents, ethnographic accounts, and missionary and explorers' writings. This evidence has allowed me to explore the complex problem of infant welfare, a topic that has not received adequate attention from historians writing about Africa.