The Lomidine Files: The Untold Story of a Medical Disaster in Colonial Africa by Guillaume Lachenal

Abstract

Reviewed by: The Lomidine Files: The Untold Story of a Medical Disaster in Colonial Africa by Guillaume Lachenal Mari K. Webel Guillaume Lachenal. The Lomidine Files: The Untold Story of a Medical Disaster in Colonial Africa. Translated by Noémi Tousignant. Baltimore: Johns Hopkins University Press, 2017. 237 pp. Ill. $34.95 (978–1–4214–2323–4). Guillaume Lachenal’s engaging body of work has long been on the radar of global scholars of public health and medicine in Africa. It is, then, both a true pleasure for readers and vital addition to Anglophone literature in the field that we now have his monograph, The Lomidine Files, in Noémi Tousignant’s elegant translation from the original French. The Lomidine Files is an ambitious and incisive study of pentamidine (known in France as Lomidine), a drug that was used widely in the 1950s and 1960s against sleeping sickness, a fatal parasitic disease. The book examines several intertwined phenomena of the postwar era: French colonial mass medicine, international and intercolonial pharmaceutical research, and changing strategies to treat and prevent sleeping sickness. In biannual or yearly campaigns, roving teams injected pentamidine into the buttocks of African populations considered by colonial authorities to be at risk for infection; these campaigns ultimately constituted the “first international mass medicine program in Africa” (p. 54). Millions of doses were injected between 1944 and 1960, primarily in French colonial territories but in Belgian, British, and Portuguese colonies as well. But, as Lachenal demonstrates, drugs do not always work as they are supposed to, and in the troubles and “misfires” of Lomidine campaigns he identifies fundamental intellectual and epistemological tensions in late colonial medicine. For Lomidine injections also led to disaster: hundreds of cases of gas gangrene and scores of deaths, particularly in French Equatorial Africa. Lachenal’s core argument is thorough and damning, demonstrating what is widely intuitive but left largely unsaid: that colonial medicine was grounded not in holistic expertise or the best science of the day, but in mediocrity, stubbornness, hasty compromise, and, ultimately, a “constitutive amnesia” in self-evaluation (p. 178). Working with [End Page 719] the concepts of bêtise and “unreason” in tandem with extensive documentary and oral evidence, Lachenal shows that the ongoing use of Lomidine despite a series of deadly “accidents” undermined the very possibility of mass medicine. Further, the book exposes colonial officials’ dangerous, racialized calculus of collective benefit against individual risk. This is an important history to bring to light. Equally so is Lachenal’s nuanced and theoretically rigorous examination of how and why Lomidine’s purported powers captivated and convinced researchers, policy makers, and practitioners to support its ongoing use in the postwar era. This is an innovative and sophisticated study that rewards sustained engagement. Though it will appeal to a wide audience interested in medical controversy or public health ethics, it is also an excellent addition to undergraduate and graduate syllabi in public health, the histories of science and medicine, world history, African studies, and development studies. The book is grounded in rigorous transnational and comparative research, producing a varied and wide-ranging history on par with recent global histories of mobile medical goods and programs, while also fundamentally advancing the scholarship on international and intercolonial dynamics of sleeping sickness control in the post–World War II era. Lachenal’s engagement with historical, anthropological, and postcolonial theory has significant payoffs in a creative, energetic methodology and also makes the book a useful, current model for interdisciplinarity. Several chapters could stand alone as companions to extant histories of interwar science or postwar international health and development; the book’s exploration of “unreason” and eradication would be particularly trenchant alongside histories of midcentury malaria eradication efforts, for example. The inclusion of longer excerpts of key primary sources throughout is a bold move, offering readers an opportunity to grapple personally with the diverse sources that Lachenal’s impressive scholarship requires. Provocative and rich vignettes at each chapter’s end allow a mindful reader to invest and participate in the book’s interpretive work and narrative arc. Ultimately, Lachenal seeks to shake the “serene entrepreneurs” of modern global health, who are focused on “simple solutions” (p. 16) or “making numbers...