Colonial Dis-Ease: US Navy Health Policies and the Chamorros of Guam, 1898-1941 (review)

Abstract

Reviewed by: Colonial Dis-Ease: US Navy Health Policies and the Chamorros of Guam, 1898-1941 Alison Bashford Anne Perez Hattori . Colonial Dis-Ease: US Navy Health Policies and the Chamorros of Guam, 1898-1941. Pacific Islands Monograph Series, no. 19. Honolulu: University of Hawai'i Press. 2004. xiv + 239 pp. Ill. $45.00 (0-8248-2808-9). This book is one answer to the question posed some time ago by Warwick Anderson in the pages of this journal: "Where is the postcolonial history of medicine?" Although the author does not quite locate her book as "postcolonial," she might well have: it is certainly an important case study in the growing historiography on U.S. military-colonial and tropical medicine in the early twentieth century—but unlike most, the fundamental research question here concerns public health and cross-cultural encounter. In a personalized coda to the book, Anne Perez Hattori mentions the uniqueness of the Guam experience, and in terms of the history of public health and of colonial and tropical medicine, this seems a fair claim. U.S. colonial administration of Guam was sudden, beginning in 1898 (squarely in the "tropical medicine" moment). It was total, in the sense that the whole island (territory and population) was under U.S. Navy administration, including Navy health and hygiene ordinances. And, as the author intriguingly points out, pre–World War II U.S. colonialism has been glossed by Chamorro memories of "American Liberation" in the war, making a critical approach to the earlier period not always welcomed. Add to this the scholarly challenge of researching and assessing the effect of earlier centuries of Spanish colonialism on indigenous health practices, and what emerges is a perfect opportunity to put medical history, colonial history, Pacific history, and U.S. history hard to work. The result is a carefully researched and neatly structured book. After several contextualizing chapters (which could have had slightly more analysis of the significance of "Navy" colonialism, rather than the more familiar Army–tropical medicine nexus), the author presents close studies of four different sites of [End Page 781] intervention: the management of Hansen's disease; the regulation of Chamorro midwifery and maternity; the Susana Hospital, the first hospital for women and children on Guam; and the (inevitable) hookworm campaign. Some of this is familiar in twentieth-century public health historiography, even if we have here excellent examples: the criminalization discourses in management of the infected, in particular those with Hansen's disease; the link between cleanliness, racialization, and modernization; the overriding of "lay" women's health practices and epistemologies by those of expert men; the surveillance of children and the use of education to promote hygienic conduct. In each chapter, the reader finds concrete information about the plans and ambitions of Navy personnel—realized and unrealized—and a real sense of the day-to-day implications of this sanitary administration for the Chamorros, none of whom, it seems, was untouched by the imperative of health. Admirably, Perez Hattori presents us with many perspectives: those of Chamorro children, Chamorro elite and entrepreneurs, Chamorro midwives and healers who were being displaced, Chamorro doctors and nurses whose lives were enfolded by the modern opportunities for work, education, and identity; and those of the Navy personnel themselves, as well as the U.S. wives' active philanthropic interests in women and children's health. While the U.S. Navy medical and sanitary measures are often critiqued, there is little automatic demonizing or valorizing of any of the historical agencies and actors: there is, for example, much substantiation of Chamorros' responding defiantly, opportunistically, and deferentially to Navy requirements. For medical historians and students, this is an interesting study in historical method, as well as offering a fresh substantive site for thinking about U.S. colonial medicine. In assessing indigenous practices, and Spanish influence from the seventeenth century, the author has been part anthropologist, relying on the rich scholarship of Pacific cross-cultural encounter. And she has heavily utilized oral histories, capitalizing on her own Chamorro knowledge. Each of these approaches supplements the seeming flood of archival data available—a flood precisely because Guam was so heavily administered, and because sanitation and hygiene were such a...