Sanitation, Disease and Public Health in Sierra Leone, West Africa, 1895–1922: Case Failure of British Colonial Health Policy

Abstract

This article examines the provision of medical and sanitary services by the British colonial authorities in Sierra Leone between 1895 and 1922. Focusing on the war period, it addresses the complex mix of variables which shaped Colonial Office policy towards public health, and concludes that colonial officials and the administration in Freetown were guilty of a partial abdication of their responsibility to their subjects. Throughout the period under review, the peculiar apathy exhibited by Colonial Office officials, notions of pseudo-scientific racism, the dearth of medical personnel and financial constraints, compounded by the strong, strangling arm of bureaucracy, combined to compromise public health in Sierra Leone. While the efforts of medical authorities were largely encumbered by administrative and authoritarian approaches, and while sanitary and health officers bickered over policy, Africans were left to their own devices in the midst of a smallpox epidemic and the world-ravaging influenza pandemic. The article traces the aetiology of disease in Sierra Leone and shows that by 1922 colonial approaches to public health were yet to be modified to suit the health needs of the population.