Medicine and Colonialism in Sri Lanka

  • Soma Hewa
Living reference work entry
DOI: https://doi.org/10.1007/978-94-007-3934-5_8760-2

Keywords

Western Medicine Public Health Program Plantation Industry Immigrant Worker Rockefeller Foundation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

It has been argued that Western medicine introduced by European colonizers and missionaries saved millions of lives in Africa, Asia, and the Americas (Comaroff & Comaroff, 1992). In this context, Western medicine represented a higher civilization and social order that lifted people to modern ways of life. David Livingstone, known for his religious zealotry, chose a medical career to heal the suffering of Africans: “In the glow of love which Christianity inspires, I soon resolved to devote my life to the alleviation of human misery… and therefore set myself to obtain a medical education, in order to be qualified for that enterprise” (Livingstone, 1858; Moffat, 1969). Medical missionaries believed that the eradication of fatal diseases among the indigenous people would encourage the “heathens” to embrace Christianity. Commenting on the effort to establish a public health department in India by the British colonial government in the mid-nineteenth century, Florence Nightingale observed that “it was not only a noble task but also a part of a mission to bring a higher civilization into India” (Cook, 1914). Even though Western medicine was regarded as an integral part of culture, medical services were rarely extended to the masses without reservations.

Several studies have argued that medicine and medical services in the colonies evolved in response to political and economic needs of Western imperialism. They suggest that medicine played a critical role in the expansion of imperialism in the late nineteenth and early twentieth centuries (Arnold, 1988; Headrick, 1981). Medicine, as it was introduced to non-Western societies by imperial forces, was an instrument of political, economic, and cultural domination. With the expansion of European colonialism in Asia, Africa, and Latin America, the threat of tropical disease became a major obstacle to colonial rule. New medical sciences were developed to deal with diseases such as cholera, malaria, dysentery, and yellow fever for the protection of the European troops and administrators from diseases originating in the indigenous communities (Kavadi, 1999). Radhika Ramasubban, who has done an extensive analysis of the origin and the development of Western medicine in British India, suggests that the main concern of British colonial policy was to protect the health of the British army and the European civilian population living in India. As a result, colonial medical policy in India created medical “enclaves,” leading to the exclusion of local populations. Such policies were justified by the colonial administrators who contended that the Indians were “superstitious and backward” and would not accept modern medicine even if it were offered (Ramasubban, 1988).

In the larger context of colonial rule, medicine and medical services were important political and psychological tools that bolstered the colonial grip over local populations.
  1. 1.

    It became clear that the health of the European personnel, particularly members of the military, could not be protected by measures directed at them alone when there were epidemic diseases among the native populations (Turshen, 1984; Worboys, 1988).

     
  2. 2.

    The increased trade and political interactions with the colonies led to a heavy traffic of people and materials across the continents. As a result, the increased vulnerability of Europe itself to epidemic diseases stemming from the tropics became a matter of concern (May, 1958).

     
  3. 3.

    The supply of raw materials for the industries in Europe and North America was dependent upon the productivity of the colonial labor force. Therefore, to sustain the capitalist economic development in the West, it was necessary to improve the productivity of the people in the colonies (Emmanuel, 1982).

     
  4. 4.

    The expansion of the market and future investments by the industrialized countries in these colonies were dependent upon the receptiveness of the masses to Western cultural and social values. Hence, the ability of Western medicine to eradicate diseases in these societies would “reduce the cultural autonomy of the agrarian people and make them amenable” to Western values and lifestyles (Brown, 1976).

     

Against the background of these recent interpretations of the role of medicine in colonial rule, we examine the impact of British colonial economic policies on the health of the colonial labor force in the plantation sector of Sri Lanka (formerly known as Ceylon) as a case study. The laissez-faire policy of the colonial government enabled the British planters to ignore even the most basic sanitary requirements such as latrines on the plantations in order to maximize profit. As a result, the plantations became breeding grounds for many parasitic and infectious diseases found on the island during the late nineteenth and early twentieth centuries. When the International Health Board (hereafter IHB) of the Rockefeller Foundation arrived in Sri Lanka in 1916 to set up a hookworm control campaign, there was an epidemic of hookworm infection on the plantations and the neighboring villages.

Historical Background

The British captured the Kandyan Kingdom of Sri Lanka in 1815, slaughtering thousands of natives and destroying scores of villages (Marshall, 1982\1846). Dr. Henry Marshall, a senior medical officer of the 89th Regiment that led the war against the Kandyan Kingdom, wrote that “the incursions of our troops into the Kandyan territory… were calculated to fill the population with the most unfavorable opinions of our justice and humanity, and to confirm the worst prejudices against the European race.” As Marshall predicted, the bitterness of the war persisted among the Kandyan Sinhalese for a long time. When the British established plantation industries in central Sri Lanka during the mid-nineteenth century, the Kandyans refused to work on the estates. To fill this deficit, laborers were brought from the southern Indian state of Tamil Nadu for the year-round work in the plantation industry. Unlike in other British colonies, such as Mauritius and the West Indies, where the Indian labor had been employed since the early nineteenth century, the colonial government never directly participated in the recruitment of Indian estate labor for Sri Lanka. The authorities maintained that Sri Lanka was close enough to India to leave such recruitment to private economic enterprises (Kodikara, 1965). The estates’ agents, or Kanganies, recruited the laborers in India. The number of laborers recruited gradually increased with the expansion of the plantation industries: coffee in the years 1841–1880, tea in the years 1890–1910, and rubber in the first two decades of the twentieth century. By the turn of the century, about 100,000 workers and their families arrived annually in Sri Lanka (Heiser, 1936; Philips, 1955).

According to the contract, the planters provided living and hospital care for the workers (Chattopadhyaya, 1979). The workers lived in barrack-like “lines” that were constructed of temporary materials. Each family was given two small rooms and as many as 12 people lived in an 8 × 10 ft room. One of the unhealthiest aspects of the living conditions on the estates was that the lines were not provided with latrines (Rockefeller Archive Center, 1914b, hereafter RAC). The workers had no choice but to relieve themselves wherever they felt the inclination. As a result, the sanitary conditions on the estates were deplorable (RAC, 1914b). The lack of government regulations over the affairs of the plantation industry made it easier for the planters to maximize their profit at the expense of the basic needs of their workers. In the extremely poor sanitary conditions on the plantations, immigrant workers and their families faced the threat of a wide range of diseases such as hookworm infection, malaria, smallpox, and cholera, which often became epidemics in many parts of the country. S. V. Balasingham, a Sri Lankan historian, describes the desperate conditions of the immigrant workers as follows: “The spread of epidemics, like cholera and smallpox in certain years in Ceylon has been traced to these immigrants and epidemics of either disease are reported to have carried away large numbers of the immigrants themselves.... There were reports in the Ceylon Times of starvation among these laborers and sale of children owing to the impossibility of maintaining them on the low wages of 6d a day” (Balasingham, 1968; Fig. 1).
Fig. 1

A typical workers’ line in the Central Province (Courtesy of the Rockefeller Archive Center)

The Prevalence of Hookworm Disease

Hookworms are tiny, slender parasites from one-half to three-quarters of an inch in length. Although parasitic in the bowel, the worm does not gain entrance through the mouth but through the pores of the skin when it comes in contact with polluted soil. The hookworm infection causes undernutrition, anemia, and lassitude. The victims of hookworm infection sometimes die because the worms literally suck away the blood necessary for life. Usually, however, death occurs because – drained of blood – the sufferers are too weak to resist new infections (Cort, 1921; Fig. 2).
Fig. 2

An example of latrines in the Dickoya estate. The materials used were jute bagging and jungle sticks. The tea factory is seen behind the latrines (Courtesy of the Rockefeller Archive Center)

The hookworm infection (anchylostomiasis) first appeared in the administration report of the Principal Civil Medical Officer (hereafter PCMO) of Sri Lanka in 1888, when 31 cases were diagnosed at general hospitals in Colombo, Badulla, and Kurunegala (Sri Lanka National Archive, 1888, hereafter SLNA). This number increased rapidly, and by 1899 about 239 deaths from anchylostomiasis had been reported in the island. According to Allan Perry, PCMO, over 80 % of the reported cases were immigrant workers, and the rest were people living in the neighboring villages of the plantation areas. “The greatest number of cases occurring in the planting districts… Yet other provinces show some cases, notably the Northern, which returned 57 cases for the year” (SLNA, 1899). Although the authorities were fully aware of the cause of the spread of the disease, they were reluctant to interfere with the private economic decisions of the planters (SLNA, 1916). Consequently, by 1916 the hookworm infection had reached epidemic proportions; more than 90 % of the population in the plantation districts was infected with the disease. Although the main cause of the spread of disease was the poor sanitary conditions in the plantation areas, the economic interest of the planters took precedence over the health of their workers (RAC, 1914). Even though a large number of the immigrant laborers arriving in Sri Lanka each year seldom lived more than “a couple of monsoons,” the planters were not concerned with the high death toll. According to K. M. de Silva, in the years 1841–1848, about 70,000 (10,000 per year) or 25 % of the immigrant workers died of various causes. These figures, according to de Silva, had been published by The Colombo Observer, a leading newspaper of the day, which argued that the death toll in Sri Lanka was much higher than that of Mauritius, where Indian laborers received relatively better treatment (de Silva, 1965). Particularly, with the proximity of Sri Lanka to South India and the large reserve of cheap labor there, the planters never felt any economic urgency to take the hookworm epidemic seriously. Moreover, the Kanganies who recruited laborers for the estates were always willing to bring as many laborers as the planters required. According to some observers, Kanganies who recruited laborers in India acted as leaders of each gang of up to 100 workers. In addition to their salaries for working as supervisors, the Kanganies received 2 % per day from each laborer’s wage under their supervision. Further, they received a bonus when their workers turned up, and therefore they made every attempt to bring as many workers as possible to the plantations (Chattopadhyaya, 1979; Fig. 3).
Fig. 3

A severely infected woman on Balacaduva estate. She is at the last stage of the disease (Courtesy of the Rockefeller Archive Center)

Philanthropic Medicine

The Rockefeller Foundation initiated the hookworm control campaign in the early 1900s, when the disease was a major health problem in the southern United States (Fosdick, 1952). The public health program was started in the South for the purpose of integrating its agricultural territory into the more stable, industrial economy controlled by the capitalists in the North. John D. Rockefeller Sr. and his close advisors believed that the disease, illiteracy, and unemployment in the South were not only causing political and civil unrest but also contributing to the sluggish economy. By improving the health and education of the whole population, beyond racial boundaries, the Rockefeller Foundation expected to expand its industrial and commercial base in the South (Brown, 1979).

The political and economic interests of the Rockefeller philanthropists were certainly not limited to the United States. They clearly recognized the interrelationship between their own personal economic interests and those of the capitalist class and the global economy in general. Consequently, with the experience of controlling hookworm infection in the South, the International Health Board of the Rockefeller Foundation (hereafter the IHB) willingly extended its capital to other countries, particularly to the British Empire. Frederick T. Gates, who was one of the architects of the Rockefeller philanthropies, wrote to John D. Rockefeller Sr. in 1905 stating that the hookworm control campaign was one of the “special programs that has direct physical and economic benefits, and a means of creating and promoting influences” (Brown, 1976). The concept of health, for the Rockefeller philanthropists, was clearly an economic term embedded in the capitalistic pursuit of global economic and political domination. They had the foresight to understand that disease has no geographical or cultural boundaries. In relation to the hookworm control program in Sri Lanka, Dr. Victor Heiser, the director of the public health program of the IHB in the East, maintained that “disease never stays at home in its natural breeding place of filth, but is ever and again breaking into the precincts of its more cleanly neighbors…. It should also have been evident to employers of colonial labor that human life had a direct monetary value… even though it might vary greatly with age and race” (Heiser, 1936). The Rockefeller philanthropists believed that if health could be achieved in the British colonies, which included the largest share of the global market, Western industrial capitalists could not only expand their trade to those countries but also influence the national political affairs of those nations. In this context, they expected that medicine would help unify and integrate the emerging industrial economies and their social and cultural values with those of less developed agrarian societies and legitimize capitalist activities by diverting attention from structural and other environmental causes of disease (Brown, 1976).

When the IHB began the hookworm control campaign in Sri Lanka in 1916, the United States was already an emerging superpower with an established military presence in the East. Following the Spanish-American war in 1898, the United States was in control of the Philippine Islands (Wolff, 1961). While the US Army Board of Health was responsible for the overall public health activities of the islands, the Rockefeller Sanitary Commission was engaged in some philanthropic work in the field of tropical sanitation. Sri Lanka was a special interest case for the IHB in the East for specific reasons pertaining to the long-term objectives of the Rockefeller Foundation. Wickliffe Rose, the director of the IHB, pointed out that Sri Lanka was a key location in Asia where a successful public health program could attract a great deal of interest in the whole region (RAC, 1915). Among some of the specific reasons that he indicated for the choice of Sri Lanka were:
  1. 1.

    The government offered a favorable administrative framework.

     
  2. 2.

    The agricultural industry provided an effective economic medium.

     
  3. 3.

    The island delimited a large, but discrete, area.

     
  4. 4.

    The geographic location of Sri Lanka in the East might tend to help spread the new knowledge and its benefits (Philips, 1955).

     

By implementing a hookworm control program for a selected group of people in the country, the IHB expected to achieve high visibility and recognition in the international community. Furthermore, by eradicating hookworm infection among the workers in the plantation industry, the Health Board believed that it could help increase productivity (Brown, 1976). In his speech to the Planters’ Association in Kandy on May 12 1916, Dr. Howard, a project advisor of the hookworm control campaign in Sri Lanka, specifically mentioned the economic benefits of the hookworm campaign. “It is of immense importance to the planters and estate owners since their profit must be dependent upon the efficiency of the labor with which they operate. Further, not only would the efficiency rate of the treated laborers increase by 20–40 %, but also they were less likely to return to India necessitating the importation of others to replace them” (RAC, 1916).

The cultural and political aspects of the location of Sri Lanka were equally important for the Rockefeller Foundation. Sri Lanka, as the center of Theravada Buddhism in the East, was identified as an important cultural “laboratory” for a public health campaign of Western medicine, the success of which could be used by the Rockefeller Foundation as an example to highlight the benefits of Western culture (Jayawardena, 1988).

Organization of the Project

The project was begun in 1916 under the direction of an American doctor, John E. Snodgrass, who reported both to the IHB of the Rockefeller Foundation and to the PCMO of Sri Lanka. All the other subordinate staff working in the project was selected locally. The immediate objectives of the project were outlined as follows:
  1. 1.

    To reduce the cost of annual recruitment of new workers by reducing morbidity and mortality.

     
  2. 2.

    To cut down hospital expenses by reducing the rate of hospital occupancy.

     
  3. 3.

    To increase the rate of fertility among female workers and to produce a native-born permanent labor force by treating anemia.

     
  4. 4.

    To increase daily productivity by reducing the number of sick workers (RAC, 1916).

     

By the end of 1922, over 600,000 people had been treated. The rate of infection dropped dramatically, and hookworm related deaths in the island declined to their lowest level of 415 per million persons in 12 years. The reduced hospitalization among workers showed the planters the economic benefits of the campaign. Annual reports emphasized the increased productivity and the reduced absenteeism. “There have been indications that the health of many has improved since the treatment. There has been an increased capacity for work” (RAC, 1918). Reports were carefully worded to avoid any misunderstanding that could jeopardize the confidence in Western medicine or the work of the Rockefeller Foundation. For example, in the case of death following treatment, the locally recruited dispensers were accused. “Careless administration of treatment… may have caused one or two deaths in the hookworm campaign. There were mistakes and instances of irresponsibility on the part of some of the local staff, but all known emergencies were met by the doctors with an almost perfect record of medical success” (RAC, 1917). American doctors working in the field often interviewed plantation management to get their reaction to the increased productivity as a result of the treatment. One planter reported that “the whole labor force is healthier… there has been very little sickness lately and… one outcome of the treatment is the pending heavy increase in the birth rate. My coolies on the whole have great faith in the treatment” (RAC, 1918).

The increased productivity immediately after the treatment created a great deal of enthusiasm among planters as well as the Rockefeller field doctors. Almost every communiqué from the field doctors to the IHB officials clearly emphasized the fact that the laborers were healthier and working hard. But this enthusiasm was not translated into fundamental sanitary reforms on the plantations. Although the field doctors insisted upon the establishment of latrines in workers’ lines, it was beyond their power to impose such orders on planters. With the experience of reinfection under poor sanitary conditions in other countries, the field doctors made a number of appeals to the Planters’ Association and colonial government for constructing latrines in the workers’ lines. They recommended the following steps for permanent control of hookworm infection on the plantation:
  1. 1.

    The construction and improvement of latrines and line compounds in order to meet basic sanitary requirements.

     
  2. 2.

    The mass treatment of all employed laborers annually until the reinfection declined to a negligible level.

     
  3. 3.

    The establishment of quarantine camps in South India, where the plantation workers originated, to treat them before leaving for Sri Lanka (RAC, 1925).

     

The Rockefeller Foundation’s hookworm control campaign on the plantation began with the understanding that the planters would take the appropriate measures to improve the sanitary conditions on the estates. However, these preventive measures required some spending which the planters did not want to undertake. As a result, the rate of reinfection continued to increase in the plantation areas. In one district alone (Matale), a year after the workers had been cured, the rate of reinfection was 88 % among a total of 3,000 persons examined (RAC, 1920a). The field doctors reluctantly admitted that the planters were unwilling to improve sanitary conditions, though they were happy to see that the laborers were being treated. In their annual reports, they recommended sanitary reforms as a fundamental requirement for the prevention of the disease. However, these cogent recommendations of the field doctors were not matched by sufficient will on the part of the IHB officials, whose mandate was to negotiate with the government and planters. For political reasons, financial contributions were approved so long as good will continued to prevail between these parties. For instance, in recommending $5,000 for a plantation company to provide treatment for their laborers, Dr. Jacocks, a senior representative of the IHB in Sri Lanka, wrote to the New York office, “I asked Dr. Rutherford [PCMO] for his opinion as to whether the granting of such a contribution by the Board at Government’s request would help to ‘heal the break’ [original emphasis] between Government and the planters. He said that he thought it would, as it should be evident to planters that the aid could not have been granted without Government consent. He thought further that a more kindly reciprocal feeling between planters and Government would follow” (RAC, 1920b). Perhaps even in a more crucial ideological sense, presented with the choice of pressing for fundamental sanitary development or continuing medical treatments, the IHB officials consistently authorized the latter, which it favored due to its bias toward curative medicine. Instructing on how to spend the $5,000 grant, Dr. Jacocks stated, “this sum to be used for post treatment as well as first treatment” (RAC, 1920b). Despite the apparent failure of the hookworm control campaign on the plantations, the IHB felt it had achieved its goal by demonstrating the relationship between the treatment for hookworm disease and increased productivity. Therefore, in 1922, the IHB decided to close its program on the plantations (Hewa, 1995).

While medicine and medical services were developed to overcome the threat of tropical diseases, these medical services were not extended to the people of the colonies until it was realized that the repeated outbreak of epidemics in the colonies would not spare the European troops and administrators. Moreover, the diseases in the colonies eventually found their way to Europe through trade. For example, the spread of cholera from India to Europe between the period of 1816 and the 1880s was a major concern that directly influenced the scientific research of John Snow, Louis Pasteur, and Robert Koch (May, 1958). While the health of the Europeans was always the first priority of colonial policy, the health of the indigenous people, as long as it did not threaten the economic and political interests of the empire, was ignored. Indian labor was exploited extensively for the expansion of the empire in Asia, Africa, and the Pacific in the same manner as African slavery was used to build the colonial economy in America and the Caribbean.

As shown, the hookworm epidemic in Sri Lanka was the result of a colonial labor policy which compromised the basic sanitary requirements of the workers for the purpose of maximizing profit. Although there was nothing inherently evil in the medical services provided by the IHB in Sri Lanka or anywhere else for that matter, the predominant interests of the IHB – as epitomized by its partiality for curative medicine – effectively precluded the success of their campaign to cure disease at their source. This curative bias of the IHB official changed over time as they continued to work in Sri Lanka. This was evident in the subsequent Health Unit Program (Hewa, 2005) begun in the late 1920s that became the foundation of the primary care system developed in the last 75 years in Sri Lanka.

References

  1. Arnold, D. (1988). Introduction: Disease, medicine and empire. In D. Arnold (Ed.), Imperial medicine and indigenous societies (pp. 1–26). Manchester: Manchester University Press.Google Scholar
  2. Balasingham, S. V. (1968). The administration of Sir Henry Ward, Governor of Ceylon, 1855–1860 (pp. 51–53). Dehiwala: Tisara Publishers.Google Scholar
  3. Brown, E. R. (1976). Public health in imperialism: Early Rockefeller programs at home and abroad. American Journal of Public Health, 66, 900–901.Google Scholar
  4. Brown, E. R. (1979). Rockefeller medicine men. Berkeley: University of California Press.Google Scholar
  5. Chattopadhyaya, H. (1979). Indians in Sri Lanka: A historical study (pp. 39–40). Calcutta: O. P. S. Publishers.Google Scholar
  6. Comaroff, J., & Comaroff, J. (1992). Ethnography and the historical imagination (pp. 215–233). Boulder: Westview Press.Google Scholar
  7. Cook, E. (1914). The life of Florence Nightingale (Vol. 2, p. 1). London: Macmillan and Company.Google Scholar
  8. Cort, W. W. (1921). Investigations on the control of hookworm disease. The American Journal of Hygiene, 1, 557–567.Google Scholar
  9. de Silva, K. M. (1965). Social policy and missionary organizations in Ceylon 1840–1855 (p. 299). London: Royal Commonwealth Society.Google Scholar
  10. Emmanuel, A. (1982). White-settler colonialism, and the myth of investment imperialism. In H. Alavi & T. Shanin (Eds.), Introduction to the sociology of developing societies (pp. 88–106). New York: Monthly Review Press.Google Scholar
  11. Fosdick, R. B. (1952). The story of the Rockefeller Foundation. New York: Harper and Brothers.Google Scholar
  12. Headrick, D. R. (1981). The tools of empire: Technology and European imperialism in the nineteenth century (pp. 58–79). New York: Oxford University Press.Google Scholar
  13. Heiser, V. (1936). An American doctor’s Odyssey (pp. 3–8). New York: W.W. Norton and Company.Google Scholar
  14. Hewa, S. (1995). Colonialism, tropical disease and imperial medicine: Rockefeller philanthropy in Sri Lanka. Lanham, MD: University of Press of America.Google Scholar
  15. Hewa, S. (2005). Globalizing primary care: Rockefeller philanthropy and the development of community-based approach to public health in Sri Lanka: What can we learn? http://archive.rockefeller.edu/publications/conferences/quinnipiac.php
  16. Jayawardena, K. (1988). Ethnic conflict in Sri Lanka and Regional Security. In Y. Sakamoto (Ed.), Asia: Militarization and regional conflict (p. 137). Tokyo: The United Nations University.Google Scholar
  17. Kavadi, S. (1999). The Rockefeller Foundation and Public Health in colonial India 1916–1945. A narrative history (pp. 1–2). Pune: Foundation for Research in Community Health.Google Scholar
  18. Kodikara, S. U. (1965). Indo-Ceylon relations since independence (pp. 5–7). Colombo: Ceylon Institute of World Affairs.Google Scholar
  19. Livingstone, D. (1858). Missionary travels and research in South Africa: Including a sketch of sixteen years’ residence in the interior of Africa (p. 5). New York: Harper and Brothers.Google Scholar
  20. Marshall, H. (1982). Ceylon: A general description of the Island and its inhabitants: With an historical sketch of the conquest of the colony by the English (p. 157). Dehiwala: Tisara Publishers. (originally published in 1846).Google Scholar
  21. May, J. (1958). The ecology of human disease (pp. 35–45). New York: MD Publications.Google Scholar
  22. Moffat, R. (1969). Missionary labors and scenes in Southern Africa. New York: Johnson Reprint Corporation. (Originally published in 1842).Google Scholar
  23. Philips, J. (1955). The hookworm campaign in Ceylon. In H. M. Teaf Jr. (Ed.), Hands across frontiers: Case studies in technical cooperation (p. 274). Leiden: A. W. Sijthoff’s Publishers.Google Scholar
  24. Ramasubban, R. (1988). Imperial health in British India. In R. MacLeod & M. Lewis (Eds.), Disease, medicine and empire (pp. 38–60). London: Routledge.Google Scholar
  25. Rockefeller Archive Center. (1914a). Summary of notes on the visit to Ceylon (pp. 1–3). Record Group 5, Series 2, Box 47.Google Scholar
  26. Rockefeller Archive Center. (1914b). Consideration of importance in connection with the control of hookworm disease in Ceylon (pp. 1–4). Record Group 5, Series 2, Box 47.Google Scholar
  27. Rockefeller Archive Center. (1915). Ceylon. 13 Record Group 1.1, Series 600, Box 2.Google Scholar
  28. Rockefeller Archive Center. (1916). Address to planters’ association by H.H. Howard (p. 1). Kandy, Ceylon. Record Group 5, Series 2, Box 48.Google Scholar
  29. Rockefeller Archive Center. (1917). Death after administration of oil of Chenopodium, Dunbar Estate, Ceylon (pp. 1–2). April 5th, 1917. Record Group 5, Series 2, Box 48.Google Scholar
  30. Rockefeller Archive Center. (1918). Ceylon anchylostomiasis campaign 13. Record Group 5, Series 3, Box 193.Google Scholar
  31. Rockefeller Archive Center. (1920a). Report on work for the relief and control of hookworm disease in Ceylon (pp. 19–21). Record Group 5, Series 2, Box 47.Google Scholar
  32. Rockefeller Archive Center. (1920b). Letter from W.P. Jacocks to V. Heiser, No.1132, May 24. Record Group 5, Series 2, Box 47.Google Scholar
  33. Rockefeller Archive Center. (1925). Report on work for the relief and control of anchylostomiasis in Ceylon (pp. 7–13). Record Group 5, Series 3, Box 195.Google Scholar
  34. Sri Lanka National Archive. (1888). Ceylon: Administration reports for the year 1888, Report of the Principal Civil Medical Officer and Inspector General of Hospitals, 126.Google Scholar
  35. Sri Lanka National Archive. (1899). Ceylon: Administration reports for the year 1899, Report of the Principal Civil Medical Officer and Inspector General of Hospitals, 4.Google Scholar
  36. Sri Lanka National Archive. (1916). Ceylon: Administration reports for the year 1916, report of the Principal Civil Medical Officer and Inspector General of Hospitals (pp. 8–11).Google Scholar
  37. Turshen, M. (1984). The political ecology of disease in Tanzania (pp. 133–153). New Brunswick: Rutgers University Press.Google Scholar
  38. Wolff, L. (1961). Little brown brother. London: Longmans.Google Scholar
  39. Worboys, M. (1988). Manson Ross and colonial medical policy: Tropical medicine in London and Liverpool 1899–1914. In R. MacLeod & M. Lewis (Eds.), Disease, medicine and empire (pp. 21–37). London: Routledge.Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  1. 1.School of Policy StudiesQueen’s UniversityKingstonCanada