ABSTRACT

Colonial rule in Nigeria was characterised by a vast array of interventions in law, land, labour, production and welfare. The cultural, demographic and political complexity of the colonial entity which emerged from various amalgamations and incorporations in the first quarter of the twentieth century; exaggerated cycles of economic expansion and contraction over the whole of the colonial period; and geographical variations in the imposition of and reaction to development agendas in the late colonial period, all interrupt a continuity of narrative on colonial policy and enterprise. In the case of the development of modern medicine, its roots in the only latterly convergent domains of missionary and government hospital-based medicine, and in sanitation, public health and epidemic control, pose further problems of interpretation. The story of how these domains articulate and interpenetrate, telescoped into a short period around the turn of the twentieth century, and how they develop into something approximating a medical system over the remainder of the colonial period and beyond, encompasses a dizzying range of medical and welfare narratives. Clinical medicine was just one of a range of sciences deployed in the

interests of colonial administration, welfare and development.1 While it took its place among ecological, entomological and laboratory sciences in the analysis of the West African disease ecology, its peculiar significance in the context of colonial rule lay in its institutional interfaces – the clinic, the hospital, the dispensary and institutions of segregation such as the asylum and the leprosarium. An understanding of how modern medicine evolved in Nigeria, in contrast to its contemporary development in Europe and North America, hinges on an appreciation of the institutional context of medical practice under colonial rule. Indeed, the insertion of ostensibly Western medical institutional forms into

settings in which they are perceived as both novel and alien has exemplified the development of modern medicine beyond Europe and North America. Further, the reach and perceived fit of modern state structures, in colonial and national politics across much of the globe, is in many respects commensurate with the sustaining of institutions for medical intervention. The ability of the state to discharge its responsibilities to a citizenry is often

envisaged with regard to health indicators, and the concomitant penetration of a responsive health sector based on biomedical intervention. The shortcomings and derelictions of the post-colonial state, often as much spatial as fiscal, demand of us an articulation of the local and provincial as a facet of the national, imperial and global. The outlines of this implicit correlation between the development of

modern medical institutions and the imposition of state authority in colonial territories can be difficult to disentangle in the history of a particular administration or institution. While the hospital seems to epitomise the modern, and to give it a determinedly local instance, the mechanisms of the articulation of medicine, locality and governance too often remain opaque and subject to speculation. This chapter considers the case of the Roman Catholic Mission (RCM) Ogoja Leprosy Scheme, founded in 1945 by Dr. Joseph Barnes in co-operation with two Irish missionary orders, the St. Patrick’s Missionary Society, and the Medical Missionaries of Mary (MMM). In this case, a resource and development politics with ramifications beyond the purely medical was grounded on government scrutiny and ratification of organisational practices which had evolved by way of careful and often fraught negotiation between medical missionaries and African community interests. In this chapter, then, I examine the way in which the systematic creation

and management of institutional spaces for leprosy control in Ogoja Province generated a bureaucratic accommodation between the government, mission and local communities which differed, both by degree, and absolutely, from any administrative machinery that had been in place earlier in the colonial history of Ogoja. The development of the RCM Ogoja Leprosy Scheme in the decade after 1945 resulted in a set of ordered interventions into the organisation of resources and of political recourse within the hinterland covered by the scheme. The land-extensive nature of early leprosy settlements and villages gave

the missionary Catholic Church an important stake in the delineation and policing of strategic and contested borders between ethnic groups, and in so doing, helped to constitute ethnicity in an absolute relation with the concepts of territory and ownership. The discursive labours involved in establishing the competencies and spheres of influence of the church, the colonial administration and political actors within local communities are clearly reflected in the record of conflict over taxation, payment, markets and resource rights, while the uneasy distinction between such fiduciary categories provides a strong index of the nature and course of changes wrought by such a large-scale intervention as a leprosy control scheme. The political techniques which evolved from the context of leprosy control

in Ogoja had a decisive impact on the framing and execution of development, welfare and infrastructural projects during the colonial period, as well as on the course of medical innovation in leprosy, and more broadly, throughout the province. The refiguring of the leprosy patient as a strategic resource, resulting from a sense of ‘clan’ ownership of and responsibility for

leprosy sufferers among its people, helped to normalise and provide a basis for new interpretations of political relations and power structures in the territory at large. The coalescing languages of entitlement and development2

gave rise to novel strategies for bargaining, discriminating and petitioning, amid rapid change in the political economy of late colonial Ogoja. I begin this chapter by examining the confrontation in practice between

the aspirational language of leprosy control elaborated by Dr. Joseph Barnes in his original proposals for leprosy control in Ogoja, and the unexpected everyday problems of negotiating and instituting sites and structures for the leprosy villages as the planned extension of these proposals. This material offers an introduction to how contentious issues regarding land, labour, duty and taxation were broached and managed in the context of an early extension of colonial development policy in a locality hitherto peripheral to imperial infrastructural concerns. The rather haphazard methods employed in response to obstacles in

implementing the RCM Ogoja Leprosy Scheme rapidly invited official scrutiny by a raft of colonial administrative bodies. Subject to an array of inspections, supervisions and investigations, the mission was effectively forced to evolve a defensive strategy in order to anchor and safeguard its material and professional investments. This process would enable the mission to formulate policies on Catholic health-care in the face of increasingly secular and global tendencies in the administration of public health and disease control. Here, I examine the material correlatives of this broader intellectual pro-

cess, at the level of local politics, thus providing texture to the accounts of the relation between the mission and the ostensibly secular late-and postcolonial development agendas and policies.3 I show how the RCM Ogoja Leprosy Scheme mediated local expression and reception of global initiatives, how it imbued the rhetoric of development with quasi-spiritual dimensions, and how it helped organise access to strategic resources, creating in the process a Catholic language of entitlement and underpinning an iteration of modernity as much political as medical.