This was a period when germ theories of disease began to predominate in many parts of the world and pharmaceutical treatments and vaccination campaigns were on the rise [1, 2].
It was also a time when hygienic regimes in cities became more uniform .
Over the next decade, hundreds of thousands of people in the region died from the disease, causing widespread trauma and fear .
As Manson would have known, the Belgian, German, French, and British officials on the ground were no more equipped to handle the outbreak than anyone else, given their uncertainty about its etiology and the fact that there was as yet no cure.
At over 11 million square miles, Africa is the second-largest continent (after Asia) and was the last massive region of the world that Europeans colonized (between 18).
The timing and scale of European colonization matter.Health activities took on an exalted role given this ethos of improvement since they were a visible and seemingly uncontroversial way to address the needs of the continent’s people.Unsurprisingly, medical projects often received a significant portion of development funds earmarked for social welfare, and medical personnel made up the majority of employees in the technical services of each colonial state [5, 6].Indeed, historical analysis of the unintended—and the willful—harms produced during the colonial period bring to light various lessons for the present since these patterns linger and continue to affect people’s perceptions and practices.Politicians from several European countries oversaw the conquest of sub-Saharan Africa at the end of the nineteenth century, dividing the bulk of the continent between the governments of Britain, France, Germany, Belgium, Portugal, and Spain.What do we learn about ethics and international health systems when we look to the past?This essay considers this question by examining the history of colonialism in sub-Saharan Africa, focusing on the harms of conquest and on the treatment and research campaigns sponsored by nascent medical services.As they were the first to admit, the scale of their responsibilities was daunting.Money was in short supply and the number of trained personnel was rarely sufficient for the tasks .This essay examines the history of European empire building and health work in sub-Saharan Africa, focusing on four patterns that shed light on the ethics of outside interventions: (1) the epidemiological and bodily harms caused by conquest and economic development; (2) the uneven and inadequate health infrastructures established during the colonial era, including certain iatrogenic consequences; (3) the ethical ambiguities and transgressions of colonial research and treatment campaigns; and (4) the concerted and inadvertent efforts to undermine African healing practices, which were not always commensurable with introduced medical techniques.This kind of historical analysis helps us home in on different kinds of ethical problems that have grown out of past asymmetries of power—between people, professions, states, and institutions—that shape the nature of international health systems to this day.