Missions for Science

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David McBride. Missions for Science: U.S. Technology and Medicine in America's African World. New Brunswick: Rutgers University Press, 2002. 308 pp. $40.00, ISBN 0813530679.


The central premise of Missions for Science is that science and technology are responsible for an often unstated yet powerful force in American history – progress. Linking this construct to ‘social utopia’ helps explain at least one motive for bringing medicine to developing places at home and abroad. The targets here are the black Atlantic societies and these specific places exist in a unique confluence of social and political constructs and constraints that both embrace and resist the scientific and technical programs of the United States. The essential question is a fascinating one, what were the differences between the planned outcomes and the actual ones and why? What role did hegemony play in the process and ultimately did U.S. involvement actually contribute to the downfall of some societies?

In the early days of our nation, the factor most shaping technology was the plantation and slavery, the Atlantic World as an object of study is well established and the trade and ebb and flow of scientific ideas is also well documented. The Black belt South produced cotton and despite mechanization, sharecropping provided few meaningful changes. Until the 1890’s the South was essentially unchanged and diseases like malaria, yellow fever and pellagra, hookworm and others were fairly commonplace. As blacks labored in farming and sharecropping under the influence of Booker T. Washington and others, industry had moved on to scientific management and the corporate research lab was in its earliest stages. While a small but powerful black middle class emerged and tried to care for the community, they Federal government lost interest and looked abroad.

The Panama Canal Zone was worked by black labor and the semi enslaved people came from many parts of the Caribbean. Banana cultivation, railroads and canal work helped create racial and social divisions. Reinforced by the pernicious and pseudo-scientific social Darwinism of the day, people of color were seen as unfit for self governance and in need of reform. The segregation of workers actually helped to spread disease and the poor living conditions also exacerbated their plight. While there were vaccinations, yellow fever and malaria outbreaks were avoided through better hygiene and testing. Ignoring the segregation, poor schooling, mistreatment of women and a host of other social ills, the Canal project and Zone was declared a success as a technical feat and one that made progress in inoculations. Things like quinine tablets and the techniques learned in Cuba by William Gorgas and Walter Reed helped reduce or prevent the massive outbreaks that had plagued the region.

In the early twentieth century, places like Haiti were the subject of an aggressive campaign to modernize the nation and Woodrow Wilson was one of the drivers of this policy. Originally seeking to quell unrest and instability, government agencies and the military worked together to bring a form of scientific rationality to the people and Haitian government. Clearly by 1929, more than 1500 miles of roads had been constructed by the military (p. 84) as well as other infrastructure projects. It was healthcare that was, and sadly still is, among the most urgent of needed reforms. In Haiti Western medicine clashed with the indigenous practices and despite some French trained doctors, the local populace was deprived of its traditional practitioners. The fight against diseases like yaws were marketed as success in the US, however, local Haitians were never trained in fighting them and they drew resources away from primary care. Food production and cotton and coffee production were mechanized, however, these efforts were not always well received. The biggest failure on the part of the United States in Haiti appears to have been in a flawed educational plan, the Service technique, that emphasized vocational education in a society that could not support it.

Looking next at Liberia, the settlement of free blacks and missionary support should have produced a more cooperative or accepting society and prior to World War 1, the country was still struggling to develop viable economic models. Companies like Firestone set up rubber plantations with many technical employees coming from the United States while locals were sued for the intense and painful laboring functions. It was this model that prevented Liberia form modernizing as the technology was known as an ‘enclave technology’. Because the Liberian government was not a true partner and did not benefit from the revenue stream, an elite ruling class of government functionaries worked for Western interests. It was actually the New Deal and a lack of large scale projects that pulled the remaining American interests out of the country. Simply, Liberia’s democratic situation was also the cause of its demise from a technology transfer point of view. Despite more modern cities, like Monrovia, the rural areas were still plagued by poverty and disease.

Disease, limited technology, lack of education another resources and poverty were not just problems in black nations abroad, the American South was still suffering and the Black Belt was slipping away from the American mainstream. In 1924, the death rate for Blacks was 48% higher for blacks than whites with a doctor to patient ratio of 1:3300 for blacks and 1:500 for whites. (p. 137) While progress was certainly being made in areas like Rosenwald schools and even the early great migrations still saw blacks affected in disproportionate ways by items like malaria. For whatever reasons and despite advances in areas like bacteriology and biochemistry, malaria continued to be present in the area. The U.S Public Health Service and projects like the TVA helped bring better sanitary conditions to the region and the disease declined but it was new pharmacology that truly made the biggest impact. The issues of Jim Crow segregation drew attention away from specific disease and as blacks left the region the federal governments attention would soon turn away.

World War 2 saw a renewed interest in Liberia as access to North and West Africa was vital to U.S. interests. With an increased military presence came more infrastructure like ports and renewed interest in education. President William V. S. Tubman wanted foreign investment and to improve suffrage, health, commerce and agriculture. Medical care was especially important and Tubman seemed very committed to staffing a national system of health care facilities, starting with black doctors in 1944. This systemic change proved to be difficult but not without some successes and other aid poured in from the World Health Organization, the United Nations and other agencies. The discovery of iron ore and mining in the 1950’s and 1960’s also helped bring technical missions from the United States, however, it was technology and medical internal structures that were needed.

Haiti was in a similar situation in the twentieth century, they were the recipient of international aid programs, and despite gains, chronic poverty still plagued the nation. Despite advance in molecular science after World War 2, Haiti was largely bypassed by the American military industrial complex. Things like penicillin treatment for syphilis were effective but not long standing concentrating on what has been called a ‘specific etiology’. (p. 204) despite philanthropists like the Mellons trying to fill the void. Haiti also suffered when aid was sent to a corrupt central government and Duvalier was a trained physician who had worked with American Sanitary Commission, however, his dictatorship saw conditions continue to worsen. Rural Haitians seem to have been hit especially hard by the regime and calls for American involvement yielded mixed results. It was a political climate that both wanted to provide assistance and also to end support for the political system and its leaders.

Like so much else in American history, race and imperialism have joined hands to shape foreign policy and in the case of the black disapora in the South, Haiti, the Canal Zone and Liberia, technology transfer has met with mixed successes. Perhaps the story is not as totally dire as presented, however, the underlying tenet of the story is that the United States is quick to abandon a place, people, program or policy once it can claim some modicum of success. Missions for Science raises some important questions about the role of science and technology transfer and the tensions that help define its purpose. The hard and social sciences are presented here as step sisters unsure of each other and willing to compromise to a limited extent. In the end, according to McBride, American policy and programs appear to be a dysfunctional family.


Alan S. Brody Spring, 2011

Missions for Science is more of a dipstick into the roles of medical progress and technological programs measured in the black Atlantic world than it is a comprehensive study of the impact of medical change as an indicator of American hegemony. It is an interesting study question that would be greatly improved if McBride was able to narrow his study to one place. As readers, the varying level of detail and analysis can be confusing, for example, the technical medical history is quite well related as opposed to his analysis of education which are very high level. McBride uses a variety of sources and his work is well researched, however, the voice of the locals and natives are missing and this suggests more evidence for looking to one place. The same argument can be made for the various federal agencies, NGO’s, philanthropists and others whose decision making and thoughts are not well related. This is not to denigrate this work, rather it suggests that there remain many on ramps to complicate his thesis.

It is easy for readers to interpret Missions for Science as a tale of gloom, and more attention to the successes would enhance the narrative. The work does contain some statistical tables, however, this is one case where quantitative analysis would be beneficial. Arguably, McBride asks more questions than he may answer and this is a helpful historical position. Missions for Science may well occupy a unique place in the historiography, crossing African American, medical, political and social histories. The triumphal narrative is certainly not present in these case studies and I want to read this as another dimension of racism both domestically and internationally. I want to believe that this is McBride’s final, if actually unstated, conclusion.

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