Charles M Good, The steamer parish: the rise and fall of missionary medicine on an African frontier, University of Chicago Press, 2004, pp. xx, 487, illus., $30.00, £21.00 (paperback 0-226-30282-2)

Abstract

The portrait offered by Charles Good of the fates of the S.S. Chauncy Maples and the S.S. Charles Janson, wood-burning steamers upon which were built the fortunes of the Universities Mission to Central Africa (UMCA) in the Diocese of Nyasaland, exemplifies many of the contradictions of European colonialism in nineteenth- and twentieth-century Africa. Focusing on the socio-spatial ramifications of a novel transport technology, Good's elegant presentation unearths the tatters and the self-proclaimed glories of empire from the service history of a now-dilapidated hulk. Generously embracing both the poignancy of an ill-starred enterprise, and the blinkered obstinacy contributing to its eventual obsolescence, Good elaborates a thematic agenda no historian of medical mission can well ignore. At first glance, it may seem strange that a work devoting so much space and energy to the vicissitudes of mission transportation on Lake Malawi could purport to be a history of missionary medicine. However, in rapidly asserting that the history of medical mission is not primarily “about” medicine, and in contextualizing his presentation by means of a carefully reasoned depiction of missionary penetration with regard to local political economies, lacustrine ecology, and African philosophies of health and illness, Good obviates the need to ground his enquiries with respect to an epidemiological “baseline”. Though he covers such material extensively as his argument develops, it is the attuned sensitivity to place which gives this work its distinctive character. In considering the effects of social, economic, political and technical processes on populations and communities across Africa, historians have tended to assume that such processes act more or less equally across a given territory or selected area of analysis. The salience of these disciplinary habits emerge more clearly when contrasted with the concerns of geographers. Good makes explicit the links between the cost of maintaining a steamer and its drain on a poorly-resourced mission, the resulting need to use such a technological resource efficiently and effectively, the impact of local provisioning, site security (in the context of ongoing slave-raiding), and mooring on the development of the mission field, and the ramifications of technology for the politics of race, employment, education and medicine. Consequently, the exigencies driving medical mission, and the practicalities relegating it among the overall concerns of evangelists and traders, are detailed in all their manifold interactions. For the historian of medical mission, this represents a fundamental shift in sensibility, the subtleties of which are perhaps best exemplified in Good's commentary on Terence Ranger's 1981 essay on UMCA medical mission in Tanzania. Demonstrating how an aetiology recognizing human agency as a prime cause of illness could supplement, and persist alongside, biomedical models of disease causation in the social contexts of colonial and post-colonial Africa, even given the constraints placed on UMCA medical mission by financial and personnel difficulties, its insistence on celibacy among European staff, and an intentional policy of overextension of its mission surrounding Lake Malawi, Good challenges and complements Ranger's arguments, suggesting that issues internal to mission culture, contributing to its spatial extension and character, might well shape medical pluralism in Africa as much as a purported “passive resistance to ‘biomedicalisation’ ” (p. 309). Some issues with the presentation of the volume detract from its otherwise exemplary nature. Curiously, for instance, no distinction is made among illustrations between maps, photographs, and plans, all listed under the heading “figures”: a more comprehensive and clearer map of place names might also have facilitated the reading of a text which so carefully alternates thematic and chronological narrative. Arguments regarding climate, lakeshore levels, and topographical isolation of stations would have benefited from relevant maps; among these, the lack of a relief map is perhaps the most significant oversight. From the perspective of a non-geographer, if only to underline the distinctiveness of a geographic approach to the history of mission, it might help to indicate the intellectual heritage of terms such as “landscape” and “topology” with the care expended on explicating the use of the term “frontier”. These minor quibbles do not detract from an otherwise precise, sympathetic, detailed, and original depiction of the internal contradictions implied in the workings of an evangelical mission involved in medical provision in societies suffering the rapacities of political instability and unfettered imperial capitalism.