The Colonial Space of Knowledge: The Medical Mission in West Africa, Imperial Entanglements and Colonial Cleanliness

Abstract

The increasing expansion and intensity of European imperialism overseas produced new knowledge on purity, health and cleanliness, which affected the development of hygiene. This chapter begins by exploring the Basel Mission’s activities on the Gold Coast since 1828 and in Cameroon since 1885, which included far-reaching economic, social and medical policies. The involvement of the Basel Mission in delivering health care to the population in West Africa was increasingly valued by imperial policy-makers. There was a marked shift between 1885 and 1914 from an initial emphasis on the health and survival of white colonists to the teaching of hygiene to the resident population in the colonies, ostensibly for their own benefit. The improvement of “indigenous hygiene”—as it was referred to during the colonial period before World War I—became a key concern of colonial governments in Africa around 1900, for both economic and cultural reasons. The tropics provided a setting in which the Basel Mission doctors not only gained scientific reputation but also political authority.

1 Missionaries and Knowledge in a Colonial World

The Basel Mission doctors came of age in a period in which questions of hygiene dominated private lives and political agendas in European societies. At the same time, the increasing expansion and intensity of European imperialism overseas produced new knowledge on purity, health and cleanliness, which affected the development of hygiene. Christian missionaries stood at the forefront of the production of knowledge about lands and peoples previously unknown to Europeans. On the one hand, their expertise opened up new possibilities for colonial powers to access, widen and consolidate their spheres of influence. On the other, missionaries disseminated knowledge about the colonial world to a general public at home that became increasingly interested in people and places abroad. European societies developed narratives about the rest of the world based on texts, images and objects moving through missionary networks, which allowed them to reframe their own identities, transforming notions of what it meant to be white, clean and civilised.

1.1 Civilising Colonialism

Beginning in the 1870s, colonial powers entered a high imperial phase as they competed to formalise their imperial spheres of interest into colonial possessions. The Berlin Conference of 1884–1885 heralded the partition of Africa into formal European colonies. As a result of this, Europe’s imperial powers monopolised the economic, legal and jurisdictional domains of African societies, while regional chiefs, who were willing to cooperate, were put in charge of local administration.¹ The increasing importance of the evangelical missionary movement over the course of the nineteenth century accompanied Europe’s economic and political expansionism. However, the sheer diversity of missions in terms of regional backgrounds and denominational affiliations, as well as the multifarious arrangements with colonial governments and African authorities make it difficult to offer neat generalisations about attitudes to colonialism and empire during this phase of High Imperialism.²

In some cases, the Basel Mission directly participated in consolidating colonial rule by providing physical and strategic support to European governments in Africa. For example, the British repeatedly sought the advice and help of the Basel missionaries on the Gold Coast during their military campaigns against the Asante in 1874, 1896 and 1900. The Basel missionaries assisted them by gathering together people from their parishes in Akem villages to form what they called “Christian squadrons.” The British government instructed the Swiss Federal Council in Berne to extend its special gratitude to the Committee in Basel for the strong support of these African Christians, who had rendered valuable service as porters and soldiers.³ In his 1920 memoirs, the Basel missionary Otto Lädrach justified the military involvement of the Basel Mission on the Gold Coast as a necessity, “in order to preserve peace and promote the well-being of the African people.”⁴

The histories of colonialism and Christian missions are intimately related, on both practical and ideological levels. The notion of colonialism—derived from the Latin “colonus” for farmer and termed “colonisation” before Albert Venn Dicey coined “colonialism” in relation to Ireland in 1886—carries within it a civilisational dimension, going beyond the settling of territory and economic exploitation to processes of cultural and religious transformation.⁵ The idea of a civilising mission offered a common starting point for colonial states and mission societies to argue for the need for European expansionism. Although the exact meaning of a civilising mission was contested in ideological debates among and between political and religious protagonists, all agreed that Christian forces were needed when it came to the very heart of the whole colonial enterprise: the almost holy duty of civilising.⁶

Christian missions offered an overarching agenda, including literacy education, social discipline, economic arrangements, medical care and cultural values such as domesticity, dress and cleanliness that addressed both the mind and body. This has given rise to popular and scholarly caricatures of missionaries as cultural imperialists, racist patriarchal colonisers and agents of hegemonic globalising capitalism. More nuanced evaluation has been thwarted for decades due to historians’ focus on missions as an extension of colonial ideology, rather than an analysis of them in their own right. To contribute to a critical understanding of the relationship between mission and colonial histories, it is crucial to examine the theological tenets and intellectual foundations upon which Christian missionaries based their civilising mission.⁷

Gustav Warneck, the initiator of German-speaking missiology, whose texts were used as part of the curriculum in the seminary in Basel, decried “the inconsiderate self-seeking which characterises the whole commercial and political intercourse of the Christian West with the non-Christian world.” He acknowledged that “trade and colonial politics are opening the world’s doors” but regretted that at the same time they were “closing the people’s hearts to the Gospel; so that missions have liked best to seek their field of labour outside of the shadow of dispersed Christendom.”⁸ Missionary intellectuals cultivated transnational networks, met at interdenominational conferences and established correspondences and publications such as the influential Allgemeine Missionszeitschrift, edited by Warneck, which undercut their colonial loyalties and fostered a critical posture towards imperial projects perceived as detrimental to evangelisation.⁹

The Basel missionaries in West Africa, who came from Switzerland and Germany, worked on the Gold Coast, a British colony, and in Cameroon, a German colony. Although they accommodated certain German and British interests in their mission fields, the networks in which they operated transcended imperial boundaries. That is not to say that national affiliations and colonial sympathies were irrelevant, especially in the looming view of the First World War, but the Basel Mission considered and promoted itself as a supranational organisation.¹⁰ The universalistic logic of Pietism and the global aspirations of the evangelical revival movement meant that most Basel missionaries refrained from expressions of overtly nationalistic enthusiasm.¹¹ The Basel Mission often stood in a tense and ambiguous relationship with colonial governments, particularly when the latter enforced the exploitation and dispossession of people in their mission areas. To be sure, the Basel missionaries, like most of their contemporaries, did not oppose colonial rule on principle, but they did seek to civilise it. And perhaps more fundamentally, as Dana Robert suggested, they sought to convert it.¹²

1.2 Basel’s Colonial Entanglements

Basel became a hub of colonial entanglements by connecting people and money in Europe with trading, scientific, military and religious networks and institutions across the world during the colonial period. The city at the heart of the interregional triangle between Switzerland, Alsace and Wurttemberg drew on its long tradition of craftsmanship and manufacturing, financial and technological know-how and labour and capital surpluses to provide colonial powers and imperial ventures with personnel, expertise and funds, allowing them to advance their military, economic, civilisational and scientific goals. People from the region of Basel, and Switzerland more generally, served as mercenaries in colonial armies, held investments in the slave trade, participated in the evangelical missionary movement, initiated research expeditions and established trading companies in colonies all over the globe.¹³

In his seminal 2015 study on the scientists Paul and Fritz Sarasin, Bernhard C. Schär examined how the two cousins, originating from a Basel patrician family, contributed to knowledge about Celebes—known as Sulawesi in Indonesia nowadays—around 1900. Schär demonstrated that the Sarasins’ research expeditions not only relied on the assistance of the Dutch colonial army but also helped to prepare the ground for the formal colonisation of the island by the Netherlands in 1905.¹⁴ Moreover, his book sheds light on the Sarasins’ legacy in Switzerland, revealing how their colonial involvement in Southeast Asia shaped institutions such as the Natural History Museum, the Ethnological Museum and the Zoological Garden in Basel, as well as the Swiss Society for Natural Sciences and Switzerland’s first national park in Grisons.¹⁵

Another striking example is that of the Basel patrician Carl Passavant. As a member of the Society for Natural Sciences in Basel, the young physician undertook two research expeditions to the west coast of Africa between 1883 and 1885 to complete a dissertation on “Craniological Studies of the Negro and the Negro peoples.” Accompanied by a zoologist and an African assistant, he reached the territory known as the Cameroons, the coastal region around Douala, in 1883. From there, the research group repeatedly ventured inland to gather new information on people and places hitherto unknown to Europeans. This knowledge proved useful to German authorities that aspired to their own place in the imperial sun. The subsequent military interventions in Cameroon culminated in the first German colonial war in Africa.¹⁶

The more recent approach of colonial knowledge highlights how older definitions of colonialism as formalised territorial power relations limit the temporal scope and omit important forces of colonial history, such as private initiatives, non-governmental institutions and transimperial networks. This approach also reveals that colonial entanglements have changed bodies of knowledge, social conditions and cultural practices in Europe at least as much as they have affected former colonies. Passavant contributed to this process by leaving behind a rich visual legacy of 274 photographs, documenting his journey from Sierra Leone to Angola. The images of the Basel patrician venturing into tropical Africa allowed people in Switzerland to visualise their own place in an increasingly interconnected world in the 1880s, revealing how Swiss people have perceived themselves and others since the colonial period.¹⁷

In fact, people from Switzerland, and from Basel particularly, had been involved in imperial activities in Africa since at least the early seventeenth century, long before European powers formalised their interests into colonial rule. In 1611, Samuel Braun from Basel first travelled to Amsterdam before boarding a merchant ship to the west coast of Africa. As a ship’s surgeon, he participated in five of these journeys until 1620. The vessels he worked on traded cotton cloth, iron, glass beads and brass basins with gold, ivory and pepper.¹⁸ Basel’s upper class, such as Braun, invested in the West African trade, acquiring a fortune through these expeditions. Upon his return, Braun became a Member of Parliament and head surgeon of the hospital in Basel, applying his experience gained as a doctor in the tropics in the city’s healthcare system. Braun is but one example of how people from Basel participated in the colonial trade and used their assets and expertise acquired abroad to gain influence at home.¹⁹

Throughout the eighteenth and nineteenth centuries, trading companies from Basel supplied slave ships leaving the ports of the Atlantic coast with industrial products. Studies on the merchant families Faesch und Burckhardt, for instance, have shown that they didn’t content themselves with capitalising on freight but also directly invested in slave expeditions along the West African coast.²⁰ They did not shy away from operating illegally by continuing to equip slave ships after the European powers had formally banned the slave trade at the Congress of Vienna in 1815.²¹ The Basel patricians accumulated considerable wealth during the age of slavery—whether they were directly involved with the slave trade or not—which paradoxically allowed them to finance the costly enterprise of training and sending missionaries abroad to compensate for the damages caused by the European slave trade.

Basel became a focal point of the revived interest in evangelism within German-speaking Protestantism, which contributed to its cosmopolitan character. By the second half of the nineteenth century, the city on the Rhine hosted one of the earliest and largest African communities in Europe, after Paris and London.²² About 25 African women and men, some of whom were former slaves, joined the seminaries of the Basel Mission and the St. Chrischona Mission of Basel.²³ Their presence aroused public interest, which the mission societies tried to use to promote awareness for their cause across Europe by publishing biographies and photographs of their new fellows. Nearly half of them, however, succumbed to tuberculosis in the following years, eventually leading to the suspension of these training programmes.²⁴ Nevertheless, the history of the African community in nineteenth-century Basel illustrates how crucial mission societies were to early ideas of Africa and its people, particularly in Switzerland, a country without formal colonies.

1.3 The Popularity of Missionary Knowledge

Through their copious writings, missionaries conveyed stories, hopes and anxieties to readers in Europe, allowing them to imagine Africans and other people around the globe and the distant countries they inhabited. These constructions were not, of course, all about otherness, but also about imagining the self, as authors and readers of such literature sought to make sense of their own identities in colonial contexts. The role of missionaries as brokers of colonial knowledge was particularly significant in Switzerland, which had no colonies of its own. Patrick Harries has demonstrated that mission societies “played an important role in shaping the way in which the Swiss—a people severely divided by language, religion, region and class—came to see themselves as a single community.”²⁵

The Basel Mission produced vast amounts of promotional material to raise awareness for their work, generate funds and recruit volunteers. The wide array of publications included specialised periodicals for children and women, popular tractates, collector card albums, missiology journals, calendars and magazines in German, French and English dealing with specific regions or fields of activity such as medicine. The most circulated periodical was Der Evangelische Heidenbote with roughly 25,000 copies monthly around 1900. The actual audience was presumably much higher than the official circulation figures indicate, since articles were passed on, read in public and discussed in prayer meetings, devotional hours, reading circles and in Sunday schools across German-speaking Europe.²⁶ Biographies and memoirs of individual missionaries aimed to create a personal connection between the evangelists in West Africa and the public at home by depicting their struggles and glorifying their accomplishments. The Basel Mission controlled a large media enterprise through which ordinary Swiss, Germans and other Europeans learned about people and places in the colonial world from the familiarity of their own home.²⁷

Knowledge flowing through the Basel Mission’s networks was particularly interactive and persuasive due to its rich visual and material nature.²⁸ The earliest photographs from the Gold Coast and Cameroon originated from Basel missionaries, who started using cameras in West Africa in 1860. Their pictures appeared in numerous local and regional newspapers, were reproduced on calendars and postcards, and were sold at missionary bazaars and fundraising events throughout Europe. They were used by itinerant preachers, missionaries on furlough and female collectors to illustrate their presentations. They were also assembled to form magic lantern shows to inform the rural populations at home about developments in the mission field abroad.²⁹

With over 50,000 negatives, the Basel Mission archives hold a substantial body of sources with regard to the visual history of Africa.³⁰ In his introduction to the volume Images and Empire, Paul Landau highlighted why photographs were—and still are—pivotal to our knowledge of Africa in particular: “Unlike the discursive field that ‘is’ other parts of the imperial world—for instance, the Muslim Orient—the image-Africa lives on almost solely in picture form.”³¹ Considering that the European perception of the “Dark Continent” mainly consisted of visual images, the few photographs of West Africa that did exist around 1900 attracted a great deal of attention. The diffusion of pictures from the colonies reached a climax at the turn of the twentieth century due to new technical procedures that allowed for their reproduction on a large scale and the growing appetite of Europeans for images depicting the wider world. Through their use in churches, schools, mass media and advertisement, depictions of Africa and Africans became part and parcel of everyday imagery and popular culture across European societies.³²

The obsessive collecting of objects by mission societies and their material contributions to popular culture were also major factors that contributed to the popularity of missionary knowledge. The Basel Mission founded a “Museum of Ethnography and Natural History” as early as 1860, which makes it one of the oldest missionary collections on the European continent. The museum inventory grew rapidly over the following decades, since the Committee encouraged missionaries in West Africa, China and India to contribute ethnographic artefacts, natural specimens, illustrations and photographs to the collection.³³ These objects and images became widely accessible to the public through the Basel Mission’s “Ethnographic Exhibitions,” the first of which toured through Switzerland, Germany and France from 1908 to 1912.³⁴

By labelling and promoting their display as an “Ethnographic Exhibition”, the curators hoped to attract a wider audience, neither primarily concerned with evangelisation nor necessarily in favour of the Pietist cause. According to reports in the daily newspaper Basler Nachrichten, the strategy paid off.³⁵ In 1910 alone, nearly 250,000 people in Switzerland, Alsace and six German cities visited the touring exhibition.³⁶ Parts of the collection then appeared in an exhibition in the Reichstag building in Berlin and at the Swiss National Exhibition in Berne in 1914. Until the last display in 1953, the Basel Mission’s touring exhibition was presented in more than forty venues across Europe, illustrating that the appeal of their material collection extended far beyond evangelical circles and regional boundaries.³⁷ Missionary displays reached a much broader spectrum of the public than the ethnographic museums or even the colonial exhibitions of the period, as Annie E. Coombes has shown for Late Victorian and Edwardian England, by “taking articles, generally reserved for ethnographic collections, into a much more lively and equally controversial context.”³⁸

The Basel Mission also put together “mission valises” and sent them to regional support groups, schoolteachers and provincial museums in Switzerland, Wurttemberg, Alsace, Palatinate and Hessen. These boxes, weighing 15 kilograms each, contained annotated photographs, models, instruments, maps and artefacts, amounting to a DIY exhibition kit.³⁹ Crucially, the knowledge generated and disseminated by the Basel Mission also reached communities in the countryside. In a recent article, Rebekka Habermas has argued “that there was an entire rural world of colonial resonances that is still to be discovered.”⁴⁰ She demonstrates how missionary networks created a colonial public sphere that also spoke to rural populations experiencing the dislocations of modernisation in Imperial Germany.

The Basel Mission’s project in West Africa would have been doomed to failure from the beginning had it not been for the backing and enthusiasm of ordinary people in the Alemannic countryside.⁴¹ People associated with the Basel Mission travelled endlessly through villages and small towns to address societies, schools and parishes, illustrating their lectures with images and objects. These visual and material sources provide tangible evidence as to how the Basel Mission shaped popular knowledge in the late nineteenth and early twentieth centuries. By offering a lens through which people in Basel and beyond could envision the colonial world, they allowed Europeans to retool their self-awareness to incorporate Africa and other parts of the earth into their religious, scientific and political frameworks. Colonial knowledge shaped deep-seated convictions and beliefs, which in the eyes of many contemporaries made colonisation a noble and necessary undertaking. Beyond and beneath the brutal facts of military, political and economic imperialism, the mobility of people and the circulation of knowledge during the colonial era fuelled identities of place and related senses of belonging.⁴²

2 The Basel Mission in West Africa

The Basel Mission’s claim to legitimacy in West Africa was based on their desire to create and sustain a Pietist presence and to bear witness against the ravages of the European slave trade and the economic exploitation that accompanied and followed this trade. In his instruction, the Inspector Christian Blumhardt described the mission to West Africa launching in 1828 as “a redemption for the injustice committed by Europeans, so that to some extent the thousands of bleeding wounds, caused by dirty greediness and most cruel deceitfulness, can be healed.”⁴³ The Committee’s fierce determination in condemning the institution of slavery, however, was curbed by the ambivalent attitude of some Basel missionaries and the deep roots of slavery in West African societies.⁴⁴

2.1 Slavery and West Indian Christians on the Gold Coast

The first team of four Basel missionaries arrived at the colonial fort in Christiansborg on the Gold Coast in 1828, at the invitation of the Danish Crown and the Danish Lutheran Church. The beginnings of the Basel Mission in West Africa were marked by high mortality rates among their personnel and the failure to spread the gospel among the resident population. Three parties of missionaries were almost completely wiped out by disease in the late 1820s and 1830s. The Committee recalled their only surviving missionary in West Africa, Andreas Riis, in 1840, with the intention of ending their mission on the Gold Coast just as they had done earlier in Liberia.⁴⁵ By the mid-nineteenth century, mission societies in general were at the point of abandoning Africa as a viable mission field altogether. The Basel Mission, however, launched a fresh start in 1843 and asked Riis to visit the Danish and British West Indies to recruit former slaves. He returned to the Akuapem region on the Gold Coast accompanied by 24 people from the West Indies.⁴⁶

According to oral history, it was the chief of Akuapem—the so-called Okuapehene—Nana Addo Dankwa, that had encouraged Riis to bring West Indians to the Gold Coast by telling him: “When God created the world, He made a book (the Bible) for the white man and abosom (African gods) for the black man. But if you could show me a black man who reads the white man’s book, then we would surely follow you.”⁴⁷ The leaders of Akuapem had welcomed the Basel missionaries’ presence, believing that they might contribute to the state’s prosperity and development, but had remained critical of their faith.⁴⁸

The Basel Mission assumed that West Indians, who were English-speaking Christians of African descent, would serve as a role model for the people they wished to convert on the Gold Coast. This strategy was used by a range of Protestant mission societies that collaborated with exponents of the abolitionist movement to establish Christian settlements in West Africa from the late eighteenth century onwards.⁴⁹ The recruitment of freed slaves from Jamaica and Antigua in the 1840s enabled a new generation of Basel missionaries and their wives to consolidate their work on the Gold Coast. The West Indians had to commit themselves contractually to work for the Basel Mission for at least five years before returning to their home countries. In 1854, Der Evangelische Heidenbote reported that “their settlement among their fellows marks a watershed in the history of this mission,” noting that “the cases of death among our brothers have become extremely rare and the Negroes have begun to listen to the word of the cross.”⁵⁰

The Basel missionaries were instructed to diminish their manual work load to prevent exhaustion and disease following the arrival of the West Indian Christians. Besides providing hard manual labour on the Basel Mission’s construction sites and plantations, noticeably reducing the mortality rate among European missionaries, the West Indians also helped to clear the doubts and suspicions that the Akuapem leaders had about the Basel Mission. The people of Akuapem started sending their children to the Basel Mission school in Akropong, which was set up by Riis and the West Indian Alexander Clerk in 1843. Catherine Mulgrave, originating from the West Indies, and her husband, the Liberian teacher George Peter Thompson, established a second school at Christiansborg that same year.⁵¹

Soon after the opening of the school in Akropong, Riis purchased a plantation and slaves for labour, triggering anger and sanctions from the mission board in Basel.⁵² Not only were missionaries not supposed to own private property but he had also acted against a founding principle of the Basel Mission: the abolitionist cause. Time and again, the question of slavery provoked bitter disputes between the Committee in Basel and the missionaries in West Africa, who gathered at regional conferences to voice their views towards the leadership in Switzerland. An internal investigation in 1862 revealed that 23 mission members, most of whom were African catechists, owned a total of 242 slaves on the Gold Coast. The Committee responded to these findings by ordering that the slaves had to be freed within two years while guaranteeing that the owners would receive compensation.⁵³

Most Basel missionaries, by contrast, feared that the Committee’s total ban of slavery would not only discourage Africans from joining the mission but also undermine the social cohesion of their parishes. They perceived the interference in a West African institution, which they considered to be very different from the transatlantic slave trade run by Europeans, as a social, economic and moral dilemma.⁵⁴ They argued that the type of domestic slavery practised in Akuapem conceived of slaves as family members, and advocated instead for a transitional solution, invoking the complexity of West African societies that relied on intricate structures of interdependency and diverse forms of slavery.⁵⁵ The Basel missionaries had arrived on the Gold Coast soon after the transatlantic slave trade had been officially abolished. The British government enacted the 1834 Slave Emancipation Act at the coastal forts but did not decree the liberation of slaves inland until the Gold Coast became a Crown Colony in 1874. The question of slavery continued to preoccupy the Basel Mission in West Africa until 1914, despite the radical stance of the leadership in Basel.⁵⁶

Most West Indians decided to return home after their five-year stay on the Gold Coast, no doubt put off by their huge workload, low pay and the presumptuous behaviour of the Basel missionaries towards them.⁵⁷ Despite their relatively short stay, the Basel Mission would have probably quit the Gold Coast for good had it not been for their engagement. They crucially contributed to the foundation of numerous new stations and schools, most importantly the Teacher Training Institute in 1848. Graduates of the Institute included descendants of the West Indians who had stayed on the Gold Coast, as well as the first generation of Akuapem converts, often sons of regional authorities who could not rule in a matrilineal society.⁵⁸

The marriage preferences of the West Indians, whose children frequently married into African merchant families, were another important factor in contributing to both the spread of Christianity and the fostering of economic ties on the Gold Coast. The second generation of West Indians laid the foundation for the present-day Presbyterian Church of Ghana, while their economic impact was particularly clear in the agricultural sector.⁵⁹ They had brought with them coffee, tobacco, cocoyam, mango, pear and breadfruit as possible cash crops suitable for the soil and climate in Akuapem.⁶⁰ The expansion and intensification of cash crop production on the Gold Coast created new workplaces for African converts, boosting the Basel Mission’s appeal among the resident population, and increased the society’s revenue. The Basel Mission opened their first trading post in Christiansborg in 1854, where coffee from Akropong was sold for export.⁶¹

2.2 Cooperation and Conflict in German Cameroon

Cameroon was different from the Basel Mission’s other mission fields, in that they were invited to start work there because Cameroon had become a German “protectorate” in 1884 and they were perceived as a German organisation in the Kaiserreich.⁶² The first evangelical missionaries to settle in Cameroon worked for the English Baptist Missionary Society. They gained a foothold on the island of Fernando Po in 1841 and reached Victoria on the mainland in 1845, where they remained until this English enclave became part of the German colony of Cameroon. The German authorities were suspicious of the British Baptists and thus encouraged the German-speaking Pietists from Basel, who had been working on the Gold Coast since 1828, to assume mission work in the region. The Baptist Missionary Society quit Cameroon in 1885, blaming the unfavourable climate as a reason for their departure.⁶³

The support groups of the Basel Mission based in southern Germany endorsed the idea of establishing mission stations in a German colony, whereas the Committee was reluctant due to Cameroon’s size and the population’s heterogeneity.⁶⁴ These initial reservations soon faded for reasons that the Committee member Adolf Sarasin openly addressed in 1914: “We came to recognise that no German mission was capable of putting themselves forward, and to refuse to assume this task meant to surrender the whole colony to the sole influence of the Catholic mission.”⁶⁵ Resentments against Catholics, and Catholic proselytising more specifically, were a key feature of the evangelical missionary movement, which constantly tried to curb the influence of Catholic missions.⁶⁶ The Order of Pallottines, founded by Vincenz Pallotti in 1835, fuelled the Committee’s fear of the growing influence of Catholicism in Africa. The Pallottines, however, saw themselves clearly disadvantaged by the Kulturkampf in Bismarck’s Germany. They had to wait until 1890 to receive approval for missionary work in Cameroon from the Foreign Office.⁶⁷

The Basel Mission succeeded the British Baptists in 1886 by purchasing the stations Bethel and Victoria located on the coast with the help of the German Foreign Office. Their mission field in the southwest of German Cameroon covered approximately 40,000 square meters and was home to half a million people.⁶⁸ Gottlieb Munz, who the Committee had entrusted with the management of the mission in Cameroon, soon found himself in conflict with the African parishes. Baptist congregations rebelled against the Basel Mission and set up their own independent parishes, culminating in the creation of the Native Baptist Church in March of 1888, still in existence today.⁶⁹

The Basel Mission tried to prevent the proliferation of the Native Baptists with the help of the colonial government, albeit with little success.⁷⁰ They faced fierce competition in the conversion market, not only from Catholics and African Christians but also from other evangelical missionary societies. In 1890, the Basel Mission had to concede part of their parishes to the German Baptists, who settled at six locations in the southwest.⁷¹ The American Presbyterians moved from Ogowe in Gabon to the southeast of Cameroon in 1889, where they established five mission stations. In the face of this heterogenous group of serious competitors, the Basel Mission’s Inspector Walter Oettli declared in 1911 that Cameroon was a “battle ground” on which various powers “collide, mutually promote, inhibit and feud each other,” thereby creating a “peculiar mental fermentation process.”⁷²

Upon their arrival, the Basel missionaries assessed that Cameroon was home to some 250 different linguistic groups. The population at the time of formal colonisation was estimated at around 3 to 3.5 million with different Bantu groups living in coastal and forest areas.⁷³ Inhabitants on Cameroon’s coast had been in contact with Europeans, Americans, Asians and other Africans for centuries, and were therefore familiar with different Christian denominations. In contrast, the Fulbe and Sudanese communities, who lived in the grasslands in northern Cameroon, remained under Muslim influence during the German colonial era.⁷⁴ Until the takeover of Cameroon by the British and French in 1914, the Basel Mission operated through 16 main stations and 246 secondary stations with a total number of 15,112 parishioners.⁷⁵ On the Gold Coast, the Basel Mission recorded 11 main stations and 185 outposts with a total of 25,042 parishioners across two main districts, Ga and Twi, in 1914. Official mission publications estimated that one-fifth of the total population of these two districts were Basel parishioners.⁷⁶

African mission members ran most of the Basel Mission’s secondary stations in West Africa. The statistics in the Basel Mission’s annual reports show that the number of these “indigenous workers” more than quadrupled between 1885 and 1914, from an initial 134 to more than 650. In the same period, the total annual number of European male missionaries residing in West Africa lay between 25 and 140, approximately half of whom were accompanied by their wives. Meanwhile, the number of single female missionaries—referred to as “maidens” in the statistics—remained marginal.⁷⁷

The Basel missionaries often performed minor administrative tasks in West African colonies, as assessors in court proceedings, for example, while their civilising mission made them tolerated or welcome in many places. In the case of German Cameroon, the collaboration of the Basel Mission with the colonial government played an important role in Germany’s expansion into northern Cameroon. While the Basel Mission relied on stable political conditions, including military repression, the colonial administration valued the consolidating influence of the Basel missionaries in recently acquired territories.⁷⁸ However, despite a symbiotic relationship, Thorsten Altena forcefully demonstrated that the leaders of the Basel Mission did not conceive of their mission in Cameroon as a patriotic act, regularly finding themselves at odds with German colonial politics.⁷⁹ At the end of 1898, an open and protracted dispute broke out between the Basel Mission and the German administration over missionary property on Mount Cameroon and in the Buea district and, more importantly, the ill-treatment and expropriation of Cameroonians.⁸⁰

German colonial policy in Cameroon encouraged the development of large plantations for tea, cacao, coffee and oil palms. For this purpose, laws were passed that enabled the government to deprive the resident population of most of their land and to sell it cheaply to European plantation companies. Furthermore, Cameroonians were ordered to pay taxes, which meant they were forced to find new sources of income, such as working on these plantations.⁸¹ From 1900, the Basel missionaries openly defied the government’s measures in Cameroon, arguing that Africans were perfectly capable of growing the new colonial crops and that they should be permitted to farm their own land under their own management.⁸²

2.3 Economics, Linguistics and Education

The Basel Mission’s appeal for the creation of an independent class of African farmers in Cameroon was part of a set of three strategies that were aimed at transforming African societies socially and economically, deemed paramount for achieving evangelical goals. Firstly, the Basel Mission maintained the importance of establishing autonomous Christian villages, which they called “salems,” where African parishioners could build an independent economic existence outside of the dominant colonial economy.⁸³ Colonial governments in West Africa promoted foreign-controlled plantation economies that destroyed communal life and reduced many Africans to landless and often itinerant agrarian proletarians.⁸⁴ As a response to this development, the Basel Mission supported the creation of independent family-run cacao and coffee farms.⁸⁵ Tetteh Quarshie, a Ga speaker who had trained as a smith in the Basel Mission workshop in Christiansborg, became one of the most successful cacao farmers on the Gold Coast in the late nineteenth century.⁸⁶

Secondly, the Basel Mission’s strategy crucially depended on preaching the gospel in African languages.⁸⁷ This approach was rooted in the belief, traceable to Martin Luther, that an individual’s mother tongue was the only effective medium for the insight that produced conversion and salvation. The Basel missionaries were required to master the languages spoken in their mission areas, in contrast to English and American mission societies that used interpreters to communicate with the resident population.⁸⁸ Their efforts initially concentrated on administering church life, including service and catechism, in regional languages, since this promised greater evangelisation success. Over the years, the Basel missionaries translated the Bible into numerous languages they had learnt in West Africa.⁸⁹

The vernacularisation of the Bible required a degree of sensitivity, openness and adaptability on the part of the Basel missionaries, which fundamentally changed the Bible itself. “Missionary adoption of the vernacular” was, as Lamin Sanneh insisted, “tantamount to adopting indigenous cultural criteria for the message, a piece of radical indigenization far greater than the standard portrayal of mission as Western cultural imperialism.”⁹⁰ The translation process was always an exercise in mutual transformation. John Peel’s study of Anglican Church missionaries among the Yoruba demonstrated how Bible translations induced shifts in theological meaning. He showed that because missionaries and their translators among the Yoruba had to seek out vernacular expressions for their concepts, they “often ended up using terms which Muslims had introduced.”⁹¹ In an environment where Christian missionaries had to work between their own theological heritage, Yoruba beliefs and Islam, difficult conceptual choices had to be made.

Several members of the Basel Mission gained wide recognition for their expertise as translators and linguists. Johann Gottlieb Christaller and Johannes Zimmermann, who worked on the Gold Coast, put together dictionaries of the Twi and Ga-Adangme languages that are still in use to this day.⁹² The Basel Mission extended their language policy in West Africa to their schools, which conflicted with colonial policies on education. The British and German administrations in the region planned to replace African tongues with their respective national languages.⁹³ The Basel missionary Adolf Mohr reported in 1901 that the British Governor on the Gold Coast, Matthew Nathan, had told him that “vernaculars should become extinct and interpreters rendered superfluous,” upon which he allegedly replied: “Hopefully our mission will succeed in keeping them alive.”⁹⁴ Although the Basel Mission integrated English into their curricula on the Gold Coast from the mid-nineteenth century, a concession to colonial realities, regional languages remained the main medium of teaching and linguistics continued to form one of their key preoccupations.⁹⁵

Thirdly, the Basel Mission pursued an ambitious literacy and education strategy since their ideal of a spiritual rebirth required people to be able to experience the Word directly for themselves in the language of their birth.⁹⁶ Independent Bible study was central to Pietist faith, which is why the Basel Mission published a large range of so-called primers—literacy training books—in African languages. Primers were small in size and had a simple layout, which made them cheap to reproduce. The Basel Mission’s own publishing house in Basel and their printing plants on the ground in West Africa also produced tractates, Bible translations, song- and hymnbooks in regional languages. While these types of publications were not new to West Africa, the scale of their production was unprecedented, forming a vital resource for the popularisation of Christianity in the region.⁹⁷

The majority of the Basel Mission’s funds were allocated to the development of schooling. They ran a comprehensive school system in the Twi and Ga regions on the Gold Coast, from primary schools in villages to teachers’ training colleges.⁹⁸ The annual report for 1914 recorded that a total of 7,819 pupils on the Gold Coast attended one of the 157 Basel Mission schools. In Cameroon, it was a total of 22,818 pupils in 384 Basel Mission schools, most of whom were instructed by African teachers.⁹⁹ The syllabus focused on religious instruction but also included “elements of European science,” reading, writing, arithmetic, handicraft and hygiene. In the Basel Mission’s boarding schools and seminaries, classes further comprised German, history and geography.¹⁰⁰ Many people in West Africa associated converting to Christianity with the prospect of a European school education. Christianity and literacy were considered to be synonymous terms, which is illustrated by the moniker they gave to the Basel missionaries: “Europeans of the Books.”¹⁰¹

The Basel missionaries’ decisions as to which languages were recorded, translated and used in the mission schools harboured considerable potential for conflict. One language was not chosen over another simply because it was more popular or widespread. Rather, it depended on the geographical position of mission stations or the quality of the relationship between individual missionaries and regional authorities. The process of fixing, defining and demarcating a language not only divided previously related linguistic groups but missionaries also commonly created, or arguably invented, new languages by merging several into one.¹⁰² Notwithstanding that missionary linguistics constituted a source of disruption, they also represented a powerful means of expression and communication, empowering people in West Africa to challenge and oppose colonial policies and imperial exploitation. Tony Ballantyne showed, for example, that “literacy and the Bible provided successive generations of Māori leaders with new skills and knowledge that could be turned against colonization.”¹⁰³

The Basel Mission’s economic, linguistic and educational policies had a profound impact on the regions in which they operated. They were not, however, simply implemented rigidly according to the Basel Mission’s preconceived plans but rather they grew organically through interaction with African translators, intermediaries and authorities.¹⁰⁴ Since farming, translating and teaching crucially involved dialogue with African people and adoption of their frame of reference, the Basel Mission’s strategies were fundamentally shaped by these people’s concepts and willingness to cooperate. This was not least because it was usually West African Christians who introduced their fellow citizens to the Basel Mission’s economics, linguistics and education, adapting and reinterpreting them as they did so. By appropriating these three pillars of the Basel Mission’s strategy into their own frameworks, West African actors triggered the development of new narratives and ways of living, allowing for the reformulation of individual futures and collective histories.¹⁰⁵

3 Mission Medicine and Health in the Colonies

By the time the first institutions of tropical medicine saw the light of day in European metropolises around 1900, the Basel Mission had acquired more than 70 years of knowledge about health in tropical colonies. The British schools for tropical medicine and the Institut für Schiffs- und Tropenkrankheiten sought to train colonial doctors to protect the health of officials, traders and settlers, providing space for laboratory research as well as practical training before they were sent to colonial posts.¹⁰⁶ European powers were not initially interested in providing medical services to the general population in their colonies. Their focus lay on the acclimatisation and well-being of European personnel as well as the prevention of epidemic outbreaks. Colonial doctors generally worked in urban areas and overviewed large-scale measures such as soil decontamination, vaccination campaigns and segregation projects. The health care provided by the Basel Mission, in contrast, spread out into rural regions and focussed on the treatment of individual patients, including both Europeans and Africans.¹⁰⁷

3.1 The Basel Medical Mission in West Africa

Rudolf Fisch, the first scientifically trained Basel Mission doctor in West Africa, arrived in Aburi on the Gold Coast with two chests of instruments and drugs in 1885. The hill station in Aburi, about 25 miles inland from Accra and 1,450 feet above sea level, formed the headquarters of the Basel medical mission. The Committee selected Aburi due to its geographical position, centrally located between the main stations of Abokobi, Akropong and Odumase/Krobo, on the cool plateau of the Akuapem Mountain Range. Aburi was home to the first European medical facility away from the coastal towns in the entire Gold Coast Colony. During his research expedition, Mähly had assessed that Aburi was “without any doubt” the healthiest place in the mission area, mainly due to its fresh source water, compact soil and air circulation.¹⁰⁸ From March 1886, there was a telegraph connection between Aburi and Accra, meaning that the mission doctor could be notified in case of any medical emergencies on the coast.¹⁰⁹ This line was expanded to other mission stations in the following years. The medical centre in Aburi initially comprised of a sanatorium for European missionaries, housed in a two-storey building with eight patient rooms, and an outpatient clinic for African patients.¹¹⁰

Fisch swiftly implemented daily consultation hours from 2 to 5 pm. According to him, these were widely attended by “all classes of Africans from the local ‘royal’ family to the poorest, expelled leper, from the smart fetish masters to the mentally ill.”¹¹¹ In his first annual account, the mission doctor reported that he had treated more than 600 African patients, some of whom had walked for 20 hours to consult with him.¹¹² The early years of the medical mission in Aburi show that the population was quite willing to listen to and accept the medical missionary among them. Nevertheless, conversions remained rare. The Basel Mission attributed the lack of evangelising success to adverse social influences, such as the patriarchal power of elders.¹¹³ The construction of a mission hospital, where patients were confined and possibly underwent a life-changing experience, was thus seen as an important step in the advancement of the mission as a whole. The mission hospital in Aburi, comprising of a surgery room, four patient rooms and an attached clay house to host additional patients and families, was completed in 1900.¹¹⁴

The first year of the hospital in Aburi saw 22 inpatients while 1644 outpatients came to see Fisch in his practice. The number of patients grew rapidly over the next years, partially because Fisch started travelling and offering consultation hours at mission stations throughout the Gold Coast. In 1902, Fisch saw 4002 outpatients and 36 inpatients in Aburi while covering more than 3000 kilometres with his bicycle on 30 different medical tours.¹¹⁵ By 1906, the number of outpatients in Aburi had reached 7,891 and the hospital hosted 62 patients, which caused Fisch to appeal to the Committee for the expansion of the existing facilities and the dispatch of additional medical missionaries.¹¹⁶ The growing demand for mission medicine was indicative of broader economic and social shifts at the turn of the twentieth century, including the expansion of cacao cultivation, the operation of gold mines and the building of roads and railways.¹¹⁷

A crucial factor for the mounting success of the Basel medical mission was the training and employment of African assistants. Their tasks included the laborious treatment of wounds and the time-consuming operation of dispensaries. Medicines imported from Europe had to be weighed out, ointments had to be mixed and pills had to be rolled.¹¹⁸ Most of the early medical assistants were former patients who had become Basel Mission parishioners. Later, most of the medical staff was recruited from the graduate pool of the Basel Mission schools.¹¹⁹ Medical assistants played a crucial role in popularising mission medicine in their communities of origin, as David Hardiman and David Arnold have shown.¹²⁰ The Basel Mission also offered basic medical training to African pastors and schoolteachers at the hospital in Aburi, so that they could provide medical care in the villages in which they worked.¹²¹

The Committee sent a second mission doctor to the Gold Coast in 1887. Alfred Eckhardt first assisted Fisch in Aburi and then practised at the Basel Mission station in Christiansborg. In 1891, he moved to Odumase, where he opened a new hospital together with a nurse, the deaconess Klara Finckh, whom he had met during his home leave in Berlin.¹²² Finckh, a pastor’s daughter from the Wurttemberg region who had trained at the deaconessate in Hall, was the first nurse to be employed by the Basel Mission.¹²³ She provided medical care in Odumase, where more than one thousand patients sought her help in 1892, assisted Eckhardt during operations, regularly visited mission members in other parishes and sold “truly incredible quantities of wound medication,” according to Eckhardt.¹²⁴

Just two years after their arrival in Odumase, both Eckhardt and Finckh passed away in the space of five months of each other. Fisch reported that his fellow mission doctor succumbed to a liver abscess in April while the deaconess died of black water fever in September 1893.¹²⁵ Following Eckhardt’s sudden death, a new Basel Mission doctor named Friedrich Hey started practising in Aburi in 1895 and soon moved to the hospital in Odumase. Originating from the Palatinate region, Hey had trained as an orderly before joining the seminary in Basel. The Basel Mission’s house doctor, Adolf Hägler, recognised Hey’s potential as a mission doctor, recommending him as a suitable candidate to the Committee. Thereupon, Hey began a medical degree alongside his missionary training in the seminary by taking lectures at the University of Basel and assisting at the surgical department of the Bürgerspital, the city’s public hospital. Despite not having completed secondary school, Hey graduated in October of 1891 thanks to the support of the Rector of the University of Basel, Professor Julius Kollmann.¹²⁶

Five years after Hey’s arrival in West Africa, the Committee decided to transfer him to Bonaku in Cameroon, where he became the first Basel Mission doctor to practise from November 1900. Hey soon found himself in conflict with his fellow missionaries and patients to the point that a continuation of his medical work seemed impossible.¹²⁷ Disagreements arose over the prophylactic intake of quinine, which Hey encouraged and many missionaries refused, and alcohol, which the mission doctor condemned but many of his non-medical colleagues and parishioners consumed. Hey complained in a letter to the Inspector that “many missionaries would still be alive if they had led a more reasonable life.”¹²⁸ Following a heated exchange of allegations between Bonaku and Basel, Hey and his wife left Cameroon in April of 1902. Hey subsequently worked for several trading companies on the Gold Coast between 1904 and 1908, where he also temporarily served as a representative British government physician.¹²⁹

The first Basel Mission hospital in Cameroon was completed in the spring of 1902 in Douala. In the absence of a mission doctor, it was nurses, African assistants, ordinary missionaries and their spouses who administered drugs, saw to the comfort of the patients and gave spiritual advice to the ill and dying. Every major station in West Africa had an outpatient clinic, where people associated with the Basel Mission found themselves strenuously engaged in medical work, drawing on their basic knowledge while explicitly acting according to the tenets of biblical healing.¹³⁰ A number of Basel missionaries in West Africa had taken a ten and a half-month long course at the German Institute for Medical Mission in Tübingen.¹³¹ Others with an interest in health care proceeded on their own initiative. The Principal of the Basel Mission’s Girls’ Institute in Douala, for instance, dedicated herself to birth assistance and maternal health for African women from 1904.¹³²

The medical mission with academically trained physicians in Cameroon was resumed in 1907, when the Committee employed Arthur Häberlin on a three-year contract. Once again, however, quarrels between veteran missionaries and the mission doctor prevented the stabilisation of the medical mission in Cameroon.¹³³ The Committee did not renew Häberlin’s contract in May of 1910. Nonetheless, Basel Mission members based in Cameroon ensured that medical care was widely available in the areas where they operated.¹³⁴ Meanwhile on the Gold Coast, the medical mission with scientifically trained staff was further consolidated with the arrival of young and well-qualified physicians and nurses. Hermann Vortisch, who had studied in Basel, Tubingen and Munich, and practised at hospitals in Berne and Basel, filled in for Fisch in Aburi, while he was on home leave from 1903 to 1905.¹³⁵

Sophie Hertlein, who had completed a nursing course offered by the Association for Women’s Mission in Basel and taken anaesthesia classes with Professor Paul Niehans in Berne, joined Fisch upon his return to Aburi in 1905.¹³⁶ Fisch’s medical team was further strengthened in 1909 with the employment of Theodor Müller. Born to Basel missionaries from Wurttemberg, Müller had trained in Munich, Heidelberg and Karlsruhe, before joining the military as a doctor. He recalled being inspired to become a mission doctor by Fisch, who he had heard of as a child. The arrival of Müller, who was familiar with the latest developments in surgery, and two additional nurses, Emma Metzger and Berta Öchsler, led to a significant increase in operations in the hospital in Aburi.¹³⁷ The staff in Aburi now performed approximately 24,000 ambulatory treatments, including on their medical tours, and over 400 surgical interventions each year between 1909 and 1914.¹³⁸ Given the overcrowded hospital, the patients often had to find a place to stay in the village, even though the original four beds in 1900 had been increased to twelve.¹³⁹

In light of the developments in Aburi, the Committee decided upon the construction of a new, considerably larger and more modern hospital, including X-ray equipment. The Basel Mission Trading Company, which had made enormous gains in the cacao business on the Gold Coast in recent years, donated 250,000 Swiss Francs for this project.¹⁴⁰ In the spring of 1914, the Committee additionally commissioned the mission doctor Karl Huppenbauer, who was born in Akropong on the Gold Coast and had trained in medicine in Tubingen, to work at the hospital in Aburi. The outbreak of the First World War, however, abruptly ended Huppenbauer’s engagement and the reconstruction of the mission hospital in Aburi. The Basel Mission’s plans were finally executed in 1928 with the establishment of a mission hospital inland in Agogo, which remains one of the major hospitals in southern Ghana to date.¹⁴¹

The Basel Mission shunned engagement with scientific medicine until the 1880s, viewing it as a costly diversion from true evangelisation. By 1900, however, the Committee had incorporated medical training, methods and technologies into their agenda, enthusiastically endorsing medical work as a key to the hearts and minds of potential converts. This was partially due to their growing confidence in the effectiveness of scientific medicine during this period, or as Christoffer H. Grundmann expressed it: “Physicians now could cure diseases previously considered fatal, thereby allowing Christian doctors to reconsider the scriptural charge of being sent by their Lord and Master to heal.”¹⁴² Significant innovations in the conceptualisation and design of medical instruments, such as the stethoscope, pharmacological advances in drug therapy, improvements in surgery, the development of sera and vaccines, and the understanding of aetiologies at the end of the nineteenth century gave new impetus to the medical missionary venture.¹⁴³

The Basel Mission doctors portrayed their medical activities as a living example of Christ’s own work. They believed that they were able to access African communities through their medical work and hoped that people who had been indifferent to the gospel would start seeking their help for medical treatment, thereby providing an avenue of opportunity for evangelising work. Rudolf Fisch defined the medical mission as “the pursuit of our Lord’s Great Commission through physicians appointed for this purpose. The medical art is thereby put into the service of God’s Kingdom.”¹⁴⁴ The Basel Mission built up a network of health services in certain regions on the Gold Coast and in Cameroon that stretched into rural communities. With the employment of medical missionaries from the 1880s, the training of medical assistants and nurses, and the establishment of mission hospitals and outpatient clinics throughout their mission areas, the Basel Mission ensured that the resident population were exposed to the possibility of healing via scientific medicine.

3.2 Growing Interest in “Indigenous Hygiene”

The involvement of the Basel Mission in delivering health care to the African population on the Gold Coast and in Cameroon was increasingly valued by imperial policy-makers, who attached more and more importance to the physical well-being of their subjects in tropical colonies. There was a marked shift in the period between 1885 and 1914 from an initial emphasis on the health and survival of white colonists to the teaching of hygiene to the resident population in the colonies, ostensibly for their own benefit. The improvement of “indigenous hygiene”—as it was referred to during the colonial period before World War I—became a key concern of colonial governments in Africa around 1900, for both economic and cultural reasons. Reflecting their increasing involvement in public health at home, European authorities now advocated extending preventive medical measures to the colonies.¹⁴⁵

In the British Empire, medical services remained disorganised and catered mostly to European settlers and colonisers until Joseph Chamberlain became the Colonial Secretary in 1895. He defined the British expansion in Africa as “constructive imperialism,” which was based on the idea that imperialism was for the benefit of the colonised people and for the rational utilisation of colonial resources. Medicine, alongside formal education and economic changes, was thus seen as an essential component of both bringing progress to Africans and serving Britain’s imperial interests. Chamberlain made the Colonial Office an important pillar of British colonial governance and extended colonial medicine to include healthcare for African subjects.¹⁴⁶

The West African Medical Service, created in 1902, received particular attention under Chamberlain. Closely administrated from the Colonial Office in London, which controlled recruitment, pay, promotions and postings, it remained racial in its recruitment pattern and metropolitan in its administration.¹⁴⁷ Chamberlain was convinced that disease control and medical intervention were indispensable elements of Britain’s imperial mission. He appointed Patrick Manson as the Colonial Office’s first medical adviser and put government opinion and resources behind Manson’s efforts to establish the School of Tropical Medicine in London.¹⁴⁸ Chamberlain, whose political and economic support propelled the institutionalisation of tropical medicine in Great Britain, elaborated on the constructive aims of tropical medicine in 1905:

I cannot myself think of any subject of scientific research and philanthropic enterprise which is more interesting, and the duty of supporting is one, which we owe to the Empire, and from which we cannot divest ourselves whatever our political opinions may be. This duty to which I refer has increased in recent years with the continual extension of our territory, with the increase of our scientific knowledge, and our opportunities, and also with what I may call the awakening of our Imperial conscience. We owe this duty to the vast population for which we have gradually made ourselves responsible.¹⁴⁹

Chamberlain’s address at the festival dinner in aid of the London School of Tropical Medicine is indicative of the way in which tropical medicine came to be seen as integral to imperial progress. There was often a disconnect, however, between the rhetoric of colonial medical policy and what was achieved in practice. Scholars examining the complexity of public health measures in British colonies have demonstrated how fractured they remained. Regardless of the grand hopes and ambitions of imperial medical discourse, the actual workings of medical policy were always contingent on regional specificities and conditions on the ground. In terms of both practice and formulation, they relied on the agency of African or Asian intermediaries and subordinate workers.¹⁵⁰

German colonialism flourished in the very same period in which scientific medicine emerged as a dominating force in the 1880s. The health of colonised peoples, however, was not a priority of imperial policy until the early twentieth century, when the colonial agenda saw a significant reorientation after protracted, costly and controversial wars. In 1904, German troops started brutal actions to repress colonial protests and retaliate against the Herero, Nama and other communities in German South-West Africa. One year later, they started the so-called Maji Maji War in German East Africa as a response to the rebellion of several population groups there.¹⁵¹ This ruthless warfare led to a political crisis in Berlin and federal elections in 1907, coined the “Hottentot elections” by contemporaries. The restructuring of colonial bureaucracy and the appointment of Bernhard Dernburg as head of the German colonial administration in 1907 are generally considered turning points in Germany’s colonial history.¹⁵²

Dernburg, a left-liberal banker, became the State Secretary for Colonial Affairs in the newly created German Imperial Colonial Office. He emphasised the necessity of reforming economic, legal and social policies, including questions of health and medicine, with regard to the colonies: “While one used to colonise by means of destruction, one can now colonise by means of preservation, which encompasses the missionary as well as the doctor, the railway as well as the machine, the advanced theoretical and applied sciences in all fields.”¹⁵³ Research in tropical medicine was to serve this reorientation in colonial policy and German authorities began to recognise the economic, political and cultural value of a hygiene mission among the population in the colonies. Dernburg deplored that there had not been “an organised study of tropical diseases affecting the natives” since most physicians in the colonies served the military. He argued that this deficiency had to be eradicated urgently by studying the “sanitary conditions of Negroes.”¹⁵⁴

One of the most prominent figures in this new era of German colonial medicine was the physician Ludwig Külz, who was a member of the medical services in Togo and Cameroon between 1902 and 1912. He noted that “the Negro” had been “the object of fervent discussions, anthropologists study his body, missionaries address his soul” but that “his capital value” had not “gained enough importance for our practical action yet.”¹⁵⁵ In a piece for the Archiv für Schiffs- und Tropenhygiene in 1911, Külz summarised Germany’s new colonial goals in a nutshell: “The colonial economy should make use of the Negroes’ arms; hygiene should keep them strong and increase their numbers.”¹⁵⁶ The welfare of the African population ascended in the list of official priorities mainly because it was seen to be a prerequisite for economic development and growth.¹⁵⁷

While demographic discourses in European societies were characterised by growing Malthusian fears of overpopulation, a mercantilist concept of population continued to exist in the colonies, where a large population was seen as the basis for, and expression of, economic strength and imperial power.¹⁵⁸ Külz argued that “sanitary pedagogics” and the implementation of “colonial racial hygiene” were to support what he coined the koloniale Menschenökonomie—“colonial human economy.”¹⁵⁹ According to him, “natives should not only be seen as the main producers of export assets and consumers of imported goods” but particularly as the most important “source of labour supply for all European companies” since Europeans were seemingly unable to permanently acclimatise in the tropics.¹⁶⁰ This concern for human resources was one of the driving forces of German colonial medicine, alongside missionary enthusiasm and scientific and medical ambitions.

The growing interest in “indigenous hygiene” was closely linked to the Kaiserreich’s ever growing demand for able-bodied, disciplined workers. Sebastian Conrad has shown that, from the mid-1880s, the so-called workers’ question became an urgent problem of colonial policy in the German colonies. The project of educating subjects for work, however, focused just as much on the inhabitants of the colonies as on the so-called work-shy—a collective term used for all unemployed and homeless persons—in Wilhelmine Germany.¹⁶¹ Crucially, it was institutions of the Innere Mission and mission societies operating in the German colonies that took up the task of creating workers’ colonies both at home and abroad. The project of education for work only promised sustained success in conjunction with a Christian work ethic.¹⁶²

The scientific, political and religious concerns for “indigenous hygiene” were shared across imperial boundaries. In the British case, a 1912 publication by the physician Francis Fremantle emphasised the need to secure “the utmost physical efficiency and therefore welfare for the 400,000,000 inhabitants of the British Empire” since “the health of the people is the supreme law.”¹⁶³ The British Governmental Commission for Education in the Colonies even demanded that hygiene should take precedence over all other teaching subjects in the curriculum. It became a compulsory subject in primary and secondary schools in Britain’s African colonies at the turn of the century. Special attention was given to girls and young women in order to tackle the high mortality rate in children. The Basel Mission schools on the Gold Coast introduced teaching materials on hygiene published by the British government in 1906.¹⁶⁴

Hygiene no longer existed solely to preserve Europeans’ health but increasingly came to be seen as part of the civilising mission. Hans Ziemann, head of the civilian and military medical service in Cameroon from 1908, emphasised that economic, social and cultural progress of the German colonial territories was only conceivable in connection with the “hygienic conquest of Africa.”¹⁶⁵ According to him, doctors working in the colonies had a crucial role to play in the advancement of the colonial project. Likewise, Külz saw it as their duty not only “to preserve the full capacity of the indigenous people,” who represented “the colonial main value,” “the most valuable possession” and “the actual organic capital stock” of colonial power, “but also to lift them as far as possible.”¹⁶⁶ This statement reflected the colonial dual mandate, the coupling of economic interest with moralistic altruism, characteristic of this period in colonial history.¹⁶⁷

Since metropolitan policy-makers strived for economic gains and cultural improvement with minimal metropolitan investment, medical missions came to play a key role in the hygiene mission in tropical colonies. The State Secretary for Colonial Affairs Dernburg recognised that mission societies and their medical facilities offered a valuable foundation for the realisation of his vision of colonialism by means of preservation. In 1907, he wrote a confidential letter to the Councillor of the Higher Administrative Court in Berlin, Max Berner, who served as a middleman for the German mission societies, in which he expounded that the new appreciation for tropical medicine was “a very rewarding field opening up for the missions,” arguing that when the “Negro is delivered from his physical ailments and gains trust, then his mind opens up for influences of a higher nature.”¹⁶⁸

The first director of the Institute for Medical Mission in Tubingen, Max Fiebig, a former medical officer in the Royal Netherlands East Indies Army for over twenty years, emphasised that the cooperation of his institution with the Institut für Schiffs- und Tropenkrankheiten served “general patriotic interests” through “Christianisation, cultivation and hygienic uplift of the colonial peoples.”¹⁶⁹ Fiebig’s declaration highlights that the institutionalisation of tropical medicine and hygiene stemmed from scientific as well as political changes taking place in the late nineteenth century. While the growing supremacy of bacteriology and parasitology triggered a profound shift in medical research practices—most notably, the rise of the laboratory—the colonial expansion of European powers in Africa proved no less constitutive for the new discipline.

By the time colonial governments began to intensify their medical efforts towards their colonial subjects, many mission societies had already established themselves as a vital element of health care in the colonies, serving those excluded by the colonial state.¹⁷⁰ While the British and German governments in West Africa set up separate healthcare services for Europeans and Africans respectively, the Basel Mission insisted on offering healing to both.¹⁷¹ It is likely, therefore, as argued by Megan Vaughan, that Africans saw missionaries differently from either the colonising forces or government medical officers, due to the wider and more integrated role that missionaries played in their societies.¹⁷² The Basel Mission doctors used their unique position as both missionaries and medical men in tropical colonies to contribute to religious, scientific and colonial bodies of knowledge. Their role as intermediaries of hygiene between West Africa and Europe, however, highlights that the meanings and practices of purity, health and cleanliness grew out of continual and contentious negotiation processes both abroad and at home.