The Legacy of Colonial Medicine in Central Africa

Abstract: Between 1921 and 1956, French colonial governments organized medical campaigns to treat and prevent sleeping sickness. Villagers were forcibly examined and injected with medications with severe, sometimes fatal, side effects. We digitized thirty years of archival records to document the locations of campaign visits at a granular geographic level for five central African countries. We find that greater historical exposure to the campaigns reduces trust in medicine -- measured by willingness to consent to a free, non-invasive blood test -- and decreases vaccination rates. The resulting mistrust is specific to the medical sector. We examine relevance for present-day health initiatives; we find that World Bank projects in the health sector are less successful in areas with greater exposure to the campaigns.