SOCIETY, STATE, AND INFANT WELFARE: NEGOTIATING MEDICAL INTERVENTIONS IN COLONIAL TANZANIA, 1920-1950 A DISSERTATION SUBMITTED TO THE FACULTY OF THE GRADUATE SCHOOL OF THE UNIVERSITY OF MINNESOTA BY OSWALD MASEBO IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY Allen Isaacman and Tamara Giles-Vernick, co-advisers July 2010 © Oswald Masebo 2010 Acknowledgements The research and writing of this dissertation have benefited from many individuals and institutions. At the University of Minnesota, I thank my advisors, Allen Isaacman and Tamara-Giles-Vernick whose guidance and advice helped me to finish writing this dissertation. Through their constructive comments and critical questions on my chapter drafts, this dissertation is much better. They provided a model of patience and commitment to one‟s work that will continue to inspire my own intellectual and professional development. I owe a special debt of gratitude to Giles-Vernick for her willingness to work so closely with me despite the fact that she is no longer on the faculty at the University of Minnesota. In addition, I thank Anna Clark, Ronald Aminzade, and Helena Pohlandt-McCormick who, together with my advisors, formed my final oral dissertation defense committee. Many other professors provided important intellectual advice during my studies. They include Mary Jo Mayness, Thomas Wolfe, Kelesto Atkins, Edward Farmer, Sara Chambers, Malinda Linquist, Saje Mathieu, John Eyler, Fernando Arenas, Karen Brown, Ian Greaves, Helga Leitner, Elizabeth Boyle, and Susan Craddock. In Fall 2009, I was a visiting instructor of history at Carleton College, where I also presented part of my research. I benefited from the comments of Annette Igra, Clifford Clark, Sussannah Ottaway, Andrew Fisher, Adeeb Khalid, Brendan LaRocque, Victoria Morse, William i North, Seungjoo Yoon, and Serena Zabin. In addition, Jamie Monson offered friendship and intellectual advice during my stay in Minnesota. The unending discussions with fellow graduate students were equally important in my learning process. They include Jesse Bucher, Jones Sichali, Julie Weiskopf, Clement Masakure, Terence Mashingaidze, Filipe Elusio, Ireen Mudeka, Drew Thompson, Elliot James, Munyaradzi Munochiveyi, Phutego Molosiwa, David Morton, and Frank Murphy. Masakure and Mashingaidze read parts of the dissertation and provided valuable feedback. In particular, I thank Jesse Bucher, Julie Weiskopf, and Jim Johnson for their comments on the chapters and for providing important editorial advice to this dissertation. In Tanzania, I thank friends and colleagues at the University of Dar es Salaam who offered (and continue to offer) intellectual support. They include Isaria Kimambo, Frederick Kaijage, Kapepwa Tambila, Felix Chami, Betram Mapunda,Nestor Luanda, Yusufu Lawi, Audax Mabula, Charles Saanane, Emanuel Kesi, Eginald Mihanjo, Rehema Nchimbi, Gasiano Sumbai, George Ambindwile, Beatrice Lubuva, and Musa Sadock. In addition, I thank the archivists at the Tanzania National Archives (TNA) and at the East Africana section of the University of Dar es Salaam library for their help in accessing written documents that I needed for my research. ii I also thank the men and women whom I interviewed for this dissertation in 2006 and 2007. Their names appear in the reference section of this dissertation. I have mined their memories to construct a historical understanding of infant welfare from the perspectives of the descendants of Africans who negotiated medical interventions during the colonial period in southwest Tanzania. I acknowledge the institutions that financially supported my studies and research. The History Department and College of Liberal Arts of the University of Minnesota provided financial support for my studies through teaching assistantships. In addition, the Interdisciplinary Center for the Study of Global Change (ICGC), Compton Peace Fellowship, and the University of Dar es Salaam provided financial support for my dissertation research work in Tanzania. I thank them for their help. My greatest debt of gratitude is to my wife Lunangisyo and my children John and Elina. They have continuously supported and encouraged me throughout my studies. They have given me hope and reason to move forward with my studies. I also acknowledge my other family members, my mother Ezelina Masebo and my brothers Hardson (and his family) and Anelwike for their encouragement. iii Dedication This dissertation is dedicated to Lunangisyo Kashililika, John Masebo, Elina Masebo, Ezelina Masebo, Jotam Masebo, Bomani Kibona, Hardson Masebo, and Anelwike Mogha. iv Abstract This dissertation is a historical analysis of colonial state infant welfare initiatives from preventive programs of the 1920s and early 1930s to policies that integrated preventive and curative medicine in the late 1930s and 1940s in colonial Tanzania. It argues that the development of these medical interventions was a negotiated process between colonial government officials, peasants, local chiefs, welfare workers, African dressers, and medical missions. In the 1920s the British colonial government initiated the welfare programs to reduce high infant mortality rates. Government officials explained poor infant survival in terms of maternal ignorance and focused on advising mothers on proper infant care, feeding, and hygiene. The government trained African welfare workers who performed the actual work of advising mothers in the communities. Peasants, however, challenged the early preventive programs as narrowly conceived both because they ignored local medical knowledge and indigenous practices and because they excluded western curative medicine that would help them tackle infant diseases such as malaria. Using their local chiefs, peasants demanded that the colonial government incorporate curative medicine in its welfare policies. Their bargaining strategies to achieve these demands included boycotting government-run welfare centers and refusing to pay taxes. The government eventually incorporated curative medicine in its welfare programs in the late 1930s, and it trained African dressers in preventive and curative medicine. The evidence for this dissertation comes from oral interviews, written archival documents, ethnographic accounts, and missionary and explorers‟ writings. This evidence has v allowed me to explore the complex problem of infant welfare, a topic that has not received adequate attention from historians writing about Africa. vi Table of Contents Acknowledgements .............................................................................................................. i Dedication .......................................................................................................................... iv Dissertation Abstract ........................................................................................................ viii Table of Contents………………………………………………………………………vii List of Tables…………………………………………………………………………...viii List of Maps……………………………………………………………………………..ix Chapter One: Introduction: Bringing Infant Survival into the History of Colonial Medicine in Africa .............................................................................................................. 1 Chapter Two: Social Change, Cosmology, and Infant Survival during the Late Pre- Colonial and Early Colonial Periods................................................................................. 47 Chapter Three: State Ideologies and Colonial Infant Survival Interventions, 1920 – 1940 ........................................................................................................................................... 91 Chapter Four: Negotiating the Viability of Early Colonial Infant Survival Interventions, 1920 - 1940. .................................................................................................................... 134 Chapter Five: Negotiating the Incorporation of Curative Medicine into the Infant Welfare Interventions, 1930-1950 ................................................................................................ 180 Conclusion ...................................................................................................................... 230 Bibliography……………………………………………………………………………237 vii List of Tables Table 1: Attendance of Children in Mission and Government Institutions….198 viii List of Maps Map 1: Southwest Tanzania as Perceived in the Late 1890s……………. 52 ix Chapter One Introduction: Bringing Infant Survival into the History of Colonial Medicine in Africa 1.0 Argument This dissertation offers an historical construction of the interplay between colonial government political administrators, medical officials, peasant men and women, medical missions, welfare workers, and dressers1 in the development of infant survival interventions from 1920 to 1950 in colonial Tanzania. The British colonial government first initiated the interventions in the 1920s to deal with the perceived problem of high infant mortality. Colonial population surveys conducted in the early 1920s indicated that as many as half of infants in Tanzania died in their first two years of life.2 Colonial officials posited that high infant mortality was the reason behind low African population numbers in the territory, which they estimated to be 4,107,000 in 1921.3 The government officials, who claimed that maternal ignorance in infant care, feeding, and hygiene were the root causes of the problem, produced the Memorandum on Infant Welfare Policy