Global Health in Historical Perspective

[upper-level undergraduate seminar]

OVERVIEW
From SARS in East Asia and Canada to AIDS in Africa and Latin America, our globalizing
society forces us to confront health problems that transcend borders. Digital media, television
and international travel ensure that we are never unaware of them.
Yet such concerns are far from new. Many of the health challenges and proposed solutions in the
global present have their roots in the long history of European expansion across the globe. In
this course, we will examine the impact of European expansion on health, disease control and
healing. We will explore topics such as the connections between European colonization and
global pandemics of infectious disease; the history of strategies for curtailing the spread of
disease across borders; cultural, social and political underpinnings of ideas about disease
causation and disease control; how western medicine was adapted in distant, multicultural
settings; and how colonial expansion shaped the development of international and global health.
We will also use this course to reflect on legacies of the global past for the global present.
COURSE FORMAT
The course meets twice a week. This course follows a seminar format, which means that our
meetings will center on the discussion of assigned readings. Weekly readings do not exceed one
hundred pages. They generally include one or two secondary sources (an article or book excerpt
written by a historian) and short primary sources (written during the historical period). If this is
your first time taking an upper-level history class, dont worry! Throughout the semester, we
will address how to approach and write about history. We will also devote one class to
discussing and developing these skills.
GOALS
First, this course provides students with a general introduction to the role of European colonial
expansion in shaping patterns in health and healing throughout the globe. As we move forward
in time, students will also learn how European colonial expansion shaped the development of
international and global health. Throughout the course, we will reflect just as much on
continuities as change over time.
Second, this course aims to teach students how to think, read and write like historians. Rather
than merely memorizing facts, students will learn how to read and think about historical texts.
Through weekly discussions and written responses to the readings, students will learn how to
engage critically with historians interpretation of the past.
Third, this course helps students develop an appreciation for historical research as a process.
Discussions provide students with the opportunity to exchange ideas and collectively develop
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approaches to problems raised in the readings. The research paper, together with the assignments
leading up to the paper, provide students with the opportunity to use their own topic to develop a
good research question and hone their skills in analytical writing.
A fourth goal is to facilitate discussions of how history can enrich our views and understanding
of health and healing in the global present.
ACCESSING READINGS
The following book will be available for purchase at the bookstore. All other readings will be on
E-Reserve.
Norrie MacQueen, Colonialism. Harlow: Pearson Education Limited, 2007.
ASSESSMENT
1. Participation
Students must complete the reading assignments, show up on time for class and participate
actively in discussions in order to succeed in this course. You are allowed one excused absence.
Students who experience a medical or family emergency can receive an excused absence by
contacting me with proper documentation.
2. Response Papers
Students will write informal response papers based on each weeks readings. These are due the
day your selected readings are being discussed in class. Unless otherwise noted in the syllabus,
these response papers are due every week. Each student also gets one free week. Response
papers will serve as jumping off points for discussion. They are not summaries of the readings.
These papers offer students opportunities to explore thoughts or reactions to the readings.
Students might reflect on why they think the readings are significant; associations between the
course material and todays world; etc. I offer potential discussion questions to help get you
started, but you should not limit yourselves to my questions. Treat these assignments as places to
explore your own ideas.
I look for the following when assessing a response paper:

One clear argument or point. Do not simply summarize the readings. Read them
carefully, formulate an opinion and elaborate on it in a response.

References to specific parts of the readings. An argument is strongest when you can
point to the specific passages in the readings that made you develop that idea.

Format. Weekly response papers should be 1 to 2 pages, double-spaced.

Style. Use formal grammar and proofread carefully.

3. Research Paper (10-15 pages)

Students will write a research paper on a topic of interest to them in consultation with me. While
the topic may be a context or subject not directly addressed in the assigned readings, it must be
related to the course themes. The research paper will be based on both primary and secondary
sources.
4. Research Paper Assignments
These mini-assignments guide students through the process of historical research and writing.
They help students build research step by step.

Short brainstorm on a potential topic: due September 19

The goal of the assignment is to create a starting point for a conversation about a doable
topic and ways to get started. This assignment has two parts. In 1 to 2 pages, describe a
topic you might be interested in for your research paper. This does not need to be very
formal. The second part of the assignment is a conversation with me. I will arrange a
time with you for a brief meeting during Week 4.

Primary source analysis: due October 3

This assignment gives you an opportunity for some feedback on your initial work with
primary sources particular to your project. Pick one of the main primary sources you are
using in your research. In 3-4 pages, analyze the source. Take into consideration some of
the following questions: What type of source is it? Who wrote it? When and where?
Who do you think the intended audience was? How might you use this source for your
paper? In what ways, specifically, could it contribute to your research project?

Annotated bibliography: due October 17

This assignment provides you with practice in identifying and assessing useful sources in
historical research. All students will prepare a working bibliography listing sources
consulted, or anticipated as being useful, for their paper. The annotated bibliography
should contain the following: 1.) full bibliographic data according to Chicago Style
format for each of your secondary and primary sources, 2.) 3 or 4 sentences explaining
how you can use it for your essay (and why). The bibliography should contain at least 3
monographs, 3 academic articles and 3 primary sources.

Argument-based outline of the paper: due November 7

1-2 pages in length. Details TBA.
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Final presentation: due December 3 or 5

Presentations at the end of the class are an opportunity for you to reflect with your
classmates on where your independent research fits in relation to the topics, themes and
issues we addressed in classroom discussion. In 10 minutes, introduce your topic, your
research question, the argument you developed and some of your primary sources.
Explain how you think your research relates to the course.

EVALUATION
Participation: 30%
Weekly response papers: 20%
Research paper assignments: 25%
Research paper: 25%

ACADEMIC HONESTY AND PLAGIARISM

As per University policy, any use of another persons words or ideas, taken directly or
paraphrased, without citing the source is plagiarism; this includes taking material from the
Internet without citing the website. For Johns Hopkins policies on plagiarism and proper
sourcing, please refer to http://krieger.jhu.edu/writingcenter/writing_resources/ for questions on
how to properly cite your sources in please refer to the Research Guide page on the course
website.

SCHEDULE
Week 1: Introductions: What Is Empire and Why Does It Matter?
Tues, 9/3 Introductions
Thurs, 9/5
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MacQueen, Colonialism, xii-xvi

Richard Keller, Geographies of Power, Legacies of Mistrust: Colonial Medicine in the Global
Present, Historical Geography 34 (2006): 26-48.
David Arnold, Introduction: Disease, Medicine and Empire, in David Arnold, ed., Imperial
Medicine and Indigenous Societies (New York: Manchester University Press, 1988), pp. 1-26.
Discussion Questions: What are some of the different ways in which European imperial
expansion and disease/medicine have shaped one another? What relevance might attention to the
colonial past have for the health and medical issues we face in the global present?
Week 2: Disease and Conquest
Tues, 9/10
Library Research Session with Christine Ruggere, 3rd Floor of the Welch Library (1900 E.
Monument Street). Meet up at Hopkins shuttle stop by Barnes and Noble at 10:35am.
Thurs, 9/12
Norrie MacQueen, Colonialism, 1-17.
Alfred Crosby, Virgin Soil Epidemics as a Factor in the Aboriginal Depopulation in the
Americas, The William and Mary Quarterly, Third Series, 33 (April 1976), 289-299.
David Jones, Virgin Soils Revisited, The William and Mary Quarterly, Third Series, 60.4
(October 2003), 703-745.
Paul Kelton, Avoiding the Smallpox Spirits: Colonial Epidemics and Southeast Indian
Survival, Ethnohistory 51.1 (2004), 1-45.
Discussion Questions: As you read these three historians, think about how and why they differ in
their accounts of the relationship between disease and imperialism in the Americas. What is the
larger significance of this debate among historians?
Week 3: The Ills of Early Empire-Building
Tues, 9/17
Philip Curtin, The Promise and Terror of a Tropical Environment, in The Image of Africa:
British Ideas and Action, 1780-1850 (Madison: University of Wisconsin Press, 1964), 58-87.
David Arnold, The Place of The Tropics in Western Medical Ideas since 1750, Tropical
Medicine and International Health 24 (1997), pp. 303-313.
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Alan Bewell, Romantic Geography: Empire, Disease and the Construction of Pathogenic
Environments, in Romanticism and the Colonial Disease (Baltimore: Johns Hopkins University,
1999), 27-51.
Discussion Questions: What role did environment play in conceptions of health, the body and
medicine for early modern Europeans? How did this conception of health shape their approaches
to colonization? How do Curtin and Arnold define The Tropics? How did it figure in premodern European thought?
Thurs, 9/19
SOURCE: James Lind, An Essay on the Diseases Incidental to Europeans in Hot Climates with
the Method of Preventing their Fatal Consequences (London: J. and J. Richardson, 1771), Full
Title Page, xii-xv (Table of Contents), 145-158, 246-255.
SOURCE: Charles Curtis, An account of the diseases of India, as they appeared in the English
Fleet, and in the naval hospital at Madras in 1782 and 1783: with observations on ulcers, and
the hospital sores of that country etc. to which is prefixed, a view of the diseases on an
expedition, and passage of a fleet and armament to India, in 1781 (Edinburgh: Printed for W.
Laing; and Longman, Hurst, Rees and Orme and J. Murray, London), 278-283.
Discussion Questions: What are these documents? Who wrote them? Why? Who do you think
the intended audience was? What arguments do the authors make? What do you think they can
tell us about medicine and health in the context of early European expansion? Use our secondary
literature from earlier this week to develop your interpretation of the two primary sources.
**NOTE: Students are strongly encouraged to check out a really great set of tips for analyzing
primary sources at http://apps.carleton.edu/curricular/history/study/primary/.
SHORT BRAINSTORM DUE
Week 4: New World Slavery and Its Legacies
Tues, 9/24
Thomas Bender, A Nation Among Nations: America's Place in World History (Farrar, Straus and
Giroux, 2006), 53-60.
Todd L. Savitt, Black Health on the Plantation and Medical Experimentation and
Demonstration on Blacks in the Old South, Race and Medicine in Nineteenth- and TwentiethCentury America (Kent: The Kent State University Press, 2007), 53-88.
Discussion Questions: What was the plantation complex? According to Savitt, what impact
did this system have health patterns? Perceptions of health? The character of southern
medicine?
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Thurs, 9/26
Sharla Fett, Soundness, in Working Cures: Healing, Health, and Power on Southern Slave
Plantations (Chapel Hill: University of North Carolina Press, 2002), 15-35.
Barbara Bush-Slimani, Hard Labor: Women, Childbirth and Resistance in British Caribbean
Societies, History Workshop 36, Colonial and Post-Colonial History (Autumn, 1993), 83-99.
SOURCE: David Collins, Practice Rules for the Management and Medical Treatment of Negro
Slaves (London: 1803). Full Title Page, Table of Contents (iii-iv), 33-41 and 151-161. Read the
Full Title Page and Table of Contents in addition to at least one of the two sections of text.
Discussion Questions: How did the slave plantation complex shape priorities in medicine and
perceptions of health? What impact did the abolition of the slave trade have on that? What was
the legacy of the plantation economy for the development of medicine and health in the
Americas later in the nineteenth century?
Week 5: The Global Challenges of the Nineteenth Century
Tues, 10/1
Trevor Getz, Modern Imperialism and Colonialism: A Global Perspective (Pearson, 2010), 192210.
1. David Arnold, Cholera: Disease as Disorder, Colonizing the Body: State Medicine and
Epidemic Disease in Nineteenth-Century India (Berkeley: University of California Press, 1993),
159-200.
Discussion Questions: What was new (and not so new) about the experience with cholera in the
nineteenth century? How did the colonial context in India shape the British responses to the
disease? What was the legacy of European perceptions of/descriptions of cholera in India after
the mid nineteenth century?
Thurs, 10/3
1. Valeska Huber, Unification of the Globe by Disease? The International Sanitary Conferences
on Cholera, 18511894. The Historical Journal 49 (2006), 453-476.
2. Aginam, O, The Nineteenth Century Colonial Fingerprints on Public Health Diplomacy: A
Postcolonial View, Law, Social Justice & Global Development Journal 1 (2003), 12 pages.
3. SOURCE: Report to the International Sanitary Conference of a Commission from That Body,
to Which Were Referred the Questions Relative to the Origin, Endemicity, Transmissibility and
Propagation of Asiatic Cholera (Boston: 1866). Read the summary of the proceedings, which
appears at the end of the Report: International Sanitary Conference at Constantinople.
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Abstract from the Report of a Commission on Questions Regarding the Origin, Endemic
Prevalence, Transmissibility and Propagation of Cholera. (11 pages) NOT ON ERESERVES!! I will provide the link to the text.

Discussion Questions: What were the International Sanitary Conferences? Why did they come
into existence when they did? Pick two of the following actors. Using what you learned from
this weeks readings as well as last weeks, compare how you think they would have perceived
the International Sanitary Conferences and why: a French delegate, a British delegate, a delegate
from the Ottoman Empire and/or a Muslim pilgrim. What lessons can we learn from analyzing
the International Sanitary Conferences from these different perspectives?
PRIMARY SOURCE ANALYSIS DUE
Week 6: Race, Disease and Health in the Age of New Imperialism
Tues 10/8
Norrie MacQueen, Colonialism, 23-44.
1. Nancy Stepan, The New Tropical Pathology, in Picturing Tropical Nature (IIthica: Cornell
University Press, 2001), 149-179.
2. Warwick Anderson, Immunities of Empire: Race, Disease, and the New Tropical Medicine,
1900-1920, Bulletin of the History of Medicine 70.1 (1996) 94-118.
3. SOURCE: William C. Gorgas, The conquest of the tropics for the white race, Journal of the
American Medical Association, June 19, 1909 52 (25), 1967-1969.
Discussion Questions: How did the germ theory and new ideas about race shape colonizers
perceptions of health problems and solutions in colonial settings? How do these patterns
compare with what we saw in the late eighteenth and early nineteenth century? Simply put: what
was new?
Thurs 10/10
John Farley, Bilharzia: A Problem of Native Health, 1900-1950, in David Arnold, ed.
Imperial Medicine and Indigenous Societies (Manchester and New York: Manchester University
Press, 1988), 189-203.
**NO RESPONSE PAPER DUE! SOURCE ASSIGNMENT: using online access to digitized
volumes of The Lancet (link to database is available through the Hopkins online catalog), find a
brief (1-4 pages) account relevant to the definition of a tropical disease, the practice of tropical
medicine or a program of tropical hygiene written between 1890 and 1914. You are welcome to
use a photo as well. Describe what you think this source can tell us about tropical medicine
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(using both Tuesdays and Thursdays readings to support your interpretation). Be prepared to
describe your source and present your interpretation in class. And bring the source to class!
Week 7: Writing and Research Workshop
10/15 NO CLASS FALL BREAK
10/17 WRITING/RESEARCH WORKSHOP
We will spend time addressing how to refine topics, develop them into research questions and
create an argument-based outline. We will also talk about how to find and judge useful sources.
Assignments for Thursday:
Read Wayne C Booth, Gregory G. Colomb and Joseph M. Williams, From Topics to
Questions, in The Craft of Research, 3rd Edition (Chicago: University of Chicago Press, 2008),
35-50.
**NO RESPONSE PAPER DUE! ASSIGNMENT: Bring the latest version of your topic
description.
ANNOTATED BIBLIOGRAPHY DUE
Week 8: Missionaries and Medicine
Tues 10/22
David Hardiman, Introduction, in David Hardiman, ed., Healing Bodies, Saving Souls:
Medical Missions in Asia and Africa (Amsterdam: Rodopi, 2006), 5-35.
SOURCE: Medicine at the World Missionary Conference, The Lancet Volume 175, Issue
4530, 25 June 1910, 1770-1.
Discussion Questions: When and why did missionaries become involved in medicine in colonial
settings? How would you characterize the role of medicine in missionaries work in extraEuropean settings? How would you compare missionaries role in medicine to that of other
actors we have encountered in our readings?
Thurs 10/24
Terrance Ranger, Godly Medicine: The Ambiguities of Medical Mission in Southeast Tanzania,
1900-1945, Social Science and Medicine 15B (1981), 261-77.
Luise White, They Could Make Their Victims Dull: Genders and Genres, Fantasies and Cures
in Colonial Southern Uganda, The American Historical Review 100:5 (Dec., 1995), 1379-1402.

Discussion Questions: What do these historians tell us about the impact and reception of
missionary medicine in colonial settings? What methods and sources do they use to develop
their arguments?
Week 9: New Missionaries of Science: The Rockefeller Foundation
Tues 10/29
John Farley, The International Health Board, in Biharzia: A History of Imperial Tropical
Medicine (Cambridge: Cambridge University Press, 1991), 72-96.
FILM: Unhooking the Hookworm (Rockefeller Foundation International Health Board) 1920.
Discussion Questions: What was the Rockefeller Foundation? Why and in what ways did it
become involved in medicine? How and in what ways could this American philanthropic
organization fall under the category of imperial medicine?
Thurs 10/31
Anne-Emanuelle Birn and Armando Solrzano, "Public Health Policy Paradoxes: Science and
Politics in the Rockefeller Foundations Hookworm Campaign in Mexico in the 1920s," Social
Science and Medicine, 1999, 49(9): 1197-1213.
Ilana Lowy, What/who should be controlled? Opposition to yellow fever campaigns in Brazil,
1900-39, in Andrew Cunningham and Bridie Andrews, eds., Western Medicine as Contested
Knowledge, Manchester University Press, 1997, pp. 124-46.
Darwin H. Stapleton, Lessons of History? Anti-Malaria Strategies of the International Health
Board and the Rockefeller Foundation from the 1920s to the Era of DDT, Public Health
Reports March-April 2004, 119: 205-15.
Discussion Questions: What was the Rockefellers notion of scientific neutrality? What did it
look like in practice? How did local residents in parts of Central and Latin America view the
Rockefellers work and mission? What was the legacy of the Rockefellers disease control
campaigns abroad and what can we learn from them?

Week 10: Imperial Crises: Venereal Disease and Reproduction in the World War I Era
Tues 11/5
Norrie MacQueen, Colonialism, 45-48.
Trevor Getz, Modern Imperialism and Colonialism: A Global Perspective (Pearson, 2010) 291294.
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Phillipa Levine, Colonial Medicine and the Project of Modernity, and Colonial Soldiers,
White Women and the First World War, in Prostitution, Race and Politics: Policing Venereal
Disease in the British Empire (New York and London: Routledge, 2003), 37-60 and 145-176.
Discussion Questions: Why and how did venereal disease emerge as a concern during World War
I? How did European and American powers frame and approach the problem? Why?
Thurs 11/7
Carol Summers, Intimate Colonialism: The Imperial Production of Reproduction in Uganda,
1907-1925, Signs 16.4 (Summer, 1991), 787-807.
Randall Packard and Paul Epstein, Medical Research on AIDS in Africa: A Historical
Perspective, in Elizabeth Fee and Daniel M. Fox, eds., AIDS: The Making of a Chronic Disease
(Berkeley: University of California Press, 1992), 346-376.
Discussion Questions: Why did venereal disease emerge as a concern in colonies during and
immediately following World War I? How did Europeans frame the disease and its causes
among Africans? How did they tackle the disease? What was the legacy of this discourse for the
much more recent past?
ARGUMENT-BASED OUTLINE DUE
Week 11: Internationalism and Social Medicine in the Interwar Years
11/12
MacQueen, Colonialism, 51-70.
Iris Borowy, The League of Nations Health Organisation: from European to Global Health
Concerns? in Astri Andresen, William Hubbard and Teemu Ryymin, eds., International and
Local Approaches to Health and Health Care (Bergen: University of Bergen 2010), 11-30.
Discussion Questions: We have seen efforts in multilateral collaboration in health before. In
what ways was the League of Nations Health Organization different? Not so different?
11/14
Michael Worboys, The Discovery of Colonial Malnutrition, in David Arnold, ed., Imperial
Medicine and Indigenous Societies, (Manchester: Manchester University Press), 208-225.
Anne-Emanuelle Birn, Skirting the issue: women and international health in historical
perspective, American Journal of Public Health 89.3 (March 1999), 399407.
Discussion Questions: How and why did malnutrition, reproduction and childrearing become
topics of concern during the interwar years? What types of programs emerged to deal with
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them? How would you compare them to programs we have seen before? What has been the
legacy of some of these interwar approaches to health?
Week 12: Old Wine in New Bottles? WWII, Decolonization and the Transition to Global
Health
Tues 11/19
MacQueen, Colonialism, 93-121
Amy L. S. Sayward Constructing international authority in the World Health Organization in
Birth of Development: How the World Bank, Food and Agriculture Organization, and World
Health Organization Changed the World, 1945-1965 (Kent State University Press, 2006) 137160.
Sung Lee, WHO and the developing world: the contest for ideology, in Andrew Cunningham
and Bridie Andrews, eds., Western Medicine as Contested Knowledge (Manchester and New
York: Manchester University Press, 1997), 24-45.
Brock Chisholm, The World Health Organization, British Medical Journal (May 6 1950)
4661-1027
Discussion Questions: What ideology initially guided the World Health Organization and why?
What were the origins of this ideology? Why and how did that ideology become contested?
Thurs 11/21
R.M. Packard, No Other Logical Choice: Global Malaria Eradication and the Politics of
International Health in the Post-War Era." Parassitologia 40 (1998): 217-29.
Marcos Cueto Local responses in Cold War, Deadly Fevers: Malaria Eradication in Mexico,
1955-1975 (Johns Hopkins University Press, 2007). 112-158.
Paul Greenough, "Intimidation, coercion, and resistance in the final stages of the South Asian
smallpox eradication campaign, 1973-1975," Social Science and Medicine, Vol. 41, No. 5
(1995), 633-645.
Discussion Questions: Why did disease eradication emerge as an ideal goal in the postwar
period? Why specifically malaria and then smallpox? What did eradication programs look like
on the ground in local contexts? What factors shaped their implementation and reception?
Week 13: Conclusions
Tues 11/26
1. Richard Keller, Geographies of Power, Legacies of Mistrust: Colonial Medicine in the
Global Present, Historical Geography 34 (2006): 26-48.
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2. David Arnold, Introduction: Disease, Medicine and Empire, in David Arnold, ed., Imperial
Medicine and Indigenous Societies (New York: Manchester University Press, 1988), pp. 1-26.
Discussion Questions: We opened this course with two thought pieces on the relationships
between empire and health/medicine. Drawing upon what you have learned from this course,
how would you respond to these works? What would you contribute to the examples, themes
and/or arguments Arnold and Keller have addressed?
Thurs 11/28 NO CLASS
Week 14: Student Contributions to the Big Picture
Tues 12/3 Presentations of research projects
Thurs 12/5 Presentations of research projects
PAPERS AND PRESENTATIONS DUE

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