xx A History of Global Health populations and became a weapon of colonialism and capitalism. Understanding and controlling tropical diseases were central to the aims of imperial powers. For example, the Panama Canal was built as a means of increasing trade to the benefit Western capitalists. Yellow fever and malaria repeatedly halted work on the canal and related projects, killing thousands of laborers and infecting many more. When Americans took over the project in 1904, they called in William C. Gorgas, who drew upon the work of Cuban doctor, Carlos Finlay, and the American physician, Walter Reed, to control the outbreak. As head of the Panama Canal Zone Sanita- tion Commission, Gorgas implemented public health measures, including improved drinking water and sanitation systems, paved streets, window screens in houses, and the elimination of mosquito breeding areas through drainage, pes- ticides, and fumigation. He also quarantined ships arriving from regions where contagious diseases were rampant. While Gorgas’s work saved untold lives, the primary purpose of his work was to ensure public health in the service of complet- ing the Panama Canal and was in no way performed out of general concern for Indigenous populations. In some contexts, tropical medicine became itself a justification for colonial- ism. In keeping with narratives akin to Kipling’s “White Man’s Burden,” Western powers claimed that the forces of colonization were beneficent. According to this damaging narrative, Western and predominantly white authorities were agents of civilization, bringing modern infrastructure and medicine to cultures deemed “undeveloped” or “uncivilized.” This racist ideology has been woven into reli- gious and medical missions since the nineteenth century. In reality, the introduc- tion of Westerners and Western medicine into non-Western regions has caused extensive damage to Indigenous health through the destruction of traditional heal- ing systems and sources of medicine as well as the introduction of deadly new diseases. Smallpox and measles, for example, were carried around the world by imperial forces. Colonialism has led to a wide range of new health problems related to income and social inequality the displacement of populations the dis- ruption of kinship networks the depletion of natural resources such as clean water for survival and the rise of new diseases tied to global climate change, including COVID-19. In addition, Western agents have perpetrated intentional medical vio- lence on populations throughout the world. Examples include the forced steriliza- tion of Indigenous women by the U.S. Indian Health Service in the 1960s and ’70s, the nonconsensual experiments performed on African American men at Tuskegee, and the use of uninformed populations in India and Africa for human clinical trials couched as humanitarian medical brigades. In a recent article in the Lancet, Richard Horton writes that “any western medical institution more than a century old and which claims to stand for peace and justice has to confront a pain- ful truth—that its success was built on the savage legacy of colonialism” (2019). Imperialism, racism, social injustice, and medical violence—these too are woven through the history of global health. GLOBAL HEALTH: A POSTMODERN CHALLENGE The founding of the World Health Organization (WHO) on April 7, 1948, is often cited as a benchmark in the history of global health. Bound by the post–World
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