Inter-imperial Learning and African Health Care in Portuguese Angola in the Interwar Period Samuël Coghe* Summary. In the 1920s, the Angolan health services eventually established a long-debated programme of African health care called Assistência Médica aos Indígenas (AMI). This article shows that, aside from economic and humanitarian considerations, the international critique of Portugal’s colonial policies and ensuing anxieties that the country might lose its colonies were decisive in convincing political decision makers in Lisbon to provide the necessary funding for this project. The article’s main argument is that the Angolan AMI programme was profoundly and deliberately shaped by processes of inter-imperial comparison and borrowing. Efforts towards the institutionalisation of inter-imperial learning and collaboration, though backed by international organisations such as the League of Nations’ Health Or- ganisation, were often not or only partially successful, as they were caught in the complex interplay between nationalism and internationalism. Inter-imperial hierarchies of prestige conditioned whether inter-imperial borrowings were made explicit or hidden. Keywords: Angola; African health care; inter-imperial learning; colonial medicine; colonialism in Africa At the turn of the twentieth century, leading Portuguese colonial officials started to call for the urgent extension of biomedical health care provisions to the native populations in their tropical African colonies. Due to social Darwinist ideas and alarming reports on epidemic diseases and extremely high infant mortality rates, they had come to believe that the African population under their rule was diminishing, or at best stagnating, and physically degenerating. 1 Anxieties of population decline were particularly strong with regard to Angola, Portugal’s largest—and, for many, most promising—colony, as, in addition to other health problems, a new outbreak of the deadly sleeping sickness epidemic had been wreaking havoc in the north since the early 1890s. 2 With the question of European ac- climatisation in the tropics unresolved, colonialists feared that the depopulation of Angola would endanger both its economic exploration, for which a large and vigorous African work force was needed, and the civilizing mission as such. In the words of Eduardo da Costa, an *Max Planck Institute for the History of Science, Boltzmannstr. 22, 14195 Berlin, Germany. Email: scoghe@ mpiwg-berlin.mpg.de Samuël Coghe is postdoctoral fellow at the Max Planck Institute for the History of Science in Berlin. He has a PhD in History from the European University Institute in Florence. His research focuses on the history of Portuguese colonial- ism in Africa, with special attention on the history of colonial medicine, demography and anthropology. He has pre- viously published on the abolition of the slave trade and slavery in nineteenth-century Angola. © The Author 2014. Published by Oxford University Press on behalf of the Society for the Social History of Medicine. doi:10.1093/shm/hku063 Advance Access published 28 September 2014 1 See, for instance, Silva Telles, ‘These Assistência aos Indígenas’, in Sociedade de Geografia de Lisboa, I Con- gresso Colonial Nacional. Actas das Sessões (Lisboa: Typ. A Liberal, 1902), 25–6; Eduardo da Costa, Estudo sobre a Administração Civil das Nossas Possessões Afri- canas. Memória apresentada ao Congresso Colonial Nacional (Lisboa: Imprensa Nacional, 1903), 187–9. 2 A first outbreak had been signalled in the 1870s. See Jill R. Dias, ‘Famine and Disease in the History of Angola, c. 1830–1930’, Journal of African History, 1981, 22, 349–78, 371–3 and, for a contemporary report, Alberto de Souza Maia Leitão, Relatório da visita sani- taria aos concelhos de léste de Loanda mais victimados pela doença do somno (Porto: Typ. A Vapor, 1901). Social History of Medicine Vol. 28, No. 1 pp. 134–154 at MPI History of Science on January 23, 2015 http://shm.oxfordjournals.org/ Downloaded from