Mass Medicine, Disease Control, and Conflict: Collective Health Security during Late Colonialism in Africa

Following the outbreak of armed conflict in Algeria, Kenya, Rhodesia/Zimbabwe, Angola, Portuguese Guinea, and Mozambique in the 1950s and 1960s, health services and disease control programmes were confronted with significant challenges. These were acutely felt by vulnerable populations in rural areas which became the targets of ethnic and nationalist insurgency as well as counter-insurgency operations. The shift in focus of colonial policies to the contested terrain of community welfare and the militarization of colonial space turned villages into laboratories for the implementation of new forms of collective (health) security. ‘Mass medicine’, which was developed from the early 1900s with planned, top-down operations, mapping, large scale screening, curative and preventive interventions, and surveillance techniques to control and eradicate diseases, showed marked similarities with securitarian COIN-related interventions in conflict zones. This chapter analyses the entanglements of mass medicine, collective health security, and COIN strategies, as the developmentalist colonial state undertook the securitization and scientization of bio-social population management during late colonialism. In the process, it explores cognitive and behavioural aspects of coercive and persuasive strategies and interventions, showing how they evolved during protracted armed conflict in former Portuguese colonies—Angola and Portuguese Guinea—until the end of empire.