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This chapter examines the impact of colonialism on the “invention” of Vietnamese medicine (VM) in the first half of the twentieth century. It focuses more specifically on the legal framework dealing with VM in the interwar period, when Vietnamese nationalism was on the rise and French colonial authorities were assessing the “successes” and “failures” of the Assistance Médicale Indigène (AMI), the colonial health care system established in 1905. I argue that this invention was at the same time pragmatic, programmatic, and ideological; it aimed at “naturalizing” the AMI to adapt it to local medical needs within the imperial framework and French budgetary constraints. Bridging political, institutional, professional, and therapeutic spaces, this article brings into focus the process whereby VM was not only domesticated, but legally defined for the first time and given specific roles within the colonial health care system. Analysing the discourses framing VM as a “traditional,” “complementary,” and “natural” medicine, I explore the different meanings of science, toxicity, and tradition in this context, as well as the issue of accessibility to essential care. I emphasize the participation of the Vietnamese population, especially Vietnamese doctors and healers, in this process. In so doing, this article helps to reconsider the historiography of traditional medicine worldwide and underlines the importance of a postcolonial approach to a much-needed history of so-called complementary and alternative medicine (CAM). Last but not least, it highlights the impact of colonialism on the framing of a “national medicine” that would play a crucial role in post-1954 Vietnam medicalization and nation building.
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While strategies had been developed by the public authorities that had been operating in Dakar since the 1920s to contain the spread of tuberculosis, a social disease then identified as an obstacle to France's socio-political and economic projects in Dakar and West Africa, in 2019, some 40 years after Senegal's decolonization, the disease continued to be a concern for the city's health authorities. This raises several questions: Why, despite the manufacture of an anti-tuberculosis vaccine since the 1920s and the discovery of specific drugs in the 1940s and 1950s, tuberculosis continues to defy the plans implemented in Dakar to contain its spread? What has been done to halt its spread? Did the fight against tuberculosis in Dakar also involve action on the factors that contributed to the spread of the disease? Was it the implementation of TB control measures that was failing? The hypothesis underlying this thesis is that the fight against tuberculosis was not a priority for Dakar health authorities, but also that the inadequacy of the various preventive and curative measures against this disease explains the limits of the action taken so far and, consequently, the persistence of tuberculosis in this city. Through an evaluation of the organization and execution of the various measures taken since 1924, this thesis attempts to shed light on the factors explaining the persistence of tuberculosis in Dakar until 1969 and to identify continuities, and not only breaks, between the colonial and national periods in order to better understand the current place of the infectious disease in the country. It also envisages seeing with reference to what knowledge and practices were maked choices concerning measures to combat tuberculosis and seeks to study the modalities of implementation of the various measures adopted to halt the development of this disease in order to grasp distances between intentions and actions taken. In order to assess the impact of the various plans to combat tuberculosis in Dakar over the chosen period, attention is also paid to their reception and the attitudes that they have aroused among the population of Dakar.
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The influenza pandemic of 1918–1920, which killed 50 000 Canadians, spurred the creation of a federal department of public health. But in the intervening century, public health at all levels has remained, as Marc Lalonde put it in 1988, the “poor cousin” in the health care system (Lalonde 1988, p. 77). Punctuated by sporadic investment during infectious disease crises, such as polio in the early 1950s, public health is less of a priority as the cost of tertiary health interventions rises. While public health potentially involves a broad range of interventions, this paper focuses on the history of public health interventions around infectious disease. COVID-19 has forced us to relearn the importance of maintaining basic infectious/communicable disease control capacity and revealed the cost of our failure to do so. It has also drawn our attention to the intersection between social inequality, racism, and colonialism and vulnerability to disease. In addition to investing in our capacity to contain disease outbreaks as they occur, we must plan now for how to achieve greater health equity in the future by addressing underlying economic and social conditions and providing meaningful access to preventive care for all. This is how we build a truly resilient society. Governments at all levels have recognized the importance of social factors in shaping health and illness for decades. But greater health equity will result only from genuine action on this knowledge. Action will arise from public advocacy in support of prevention, and a new level of engagement and collaboration between affected individuals and communities, public health experts, and governments.