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História
by health services, and the screening and treating of
high risk populations had a big impact on the combat
against these diseases.The authors reviewed colonial re-
cords for Leopoldville (Belgian Congo) concerning the
incidence rates of diseases and demographic data. The
combined annual incidence of treated primary and sec-
ondary syphilis averaged: 1) 2,44% in the period 1919–
29 (when
Neoarsenobenzol
treatment was irregular); 2)
3.16%; during the period 1930–36, when screening
of the entire population and monitoring of commercial
sex workers was carried out; 3) 0.97% for the period
1937–47, after these efforts effectively reduced real inci-
dence; 4) 0.034% in the period 1948–58, following the
introduction of penicillin. A similar pattern was found
for other
STDs.Weconclude that the incidence rates of
these diseases follow a temporal pattern consistent with
the aforesaid treatments and health campaigns.
The paper by Bernardo Pinto Cruz,Vaccination and re-
settlement in Angola (1955-1974), deals with the mass
vaccination campaigns against polio and smallpox which
were implemented by recently reformed health services
between 1962 and 1966. Although operating through a
dense transnational network of actors and institutions,
these campaigns became part of the broader Portuguese
colonial war effort (1961-1974). Devised as a counter-
subversive technique, the delivery of vaccines to African
civilians in the countryside was presented as a major im-
provement in the domain of preventive healthcare, along
with hygiene and sanitary prevention.The author traces
the history of these large-scale operations organized at
different levels, i.e. between theWHO and other special-
ized international agencies, colonial officials in Portugal
and medical experts, administrators and military offic-
ers in Angola. He argues that the colonial war policy of
population resettlement and village-building, accompa-
nied by a reorganization of statistical procedures, led to
a growing (but otherwise small) sector of medical agents
providing the material basis for successful vaccine pro-
vision.The building of
aldeamentos
, new African villages,
which also a belated constitution of an interwar medical-
imperial dream, brought public health benefits as well as
raising several concerns, all related to an increase in Af-
rican mortality rates due to a higher prevalence of com-
municable diseases (tuberculosis, leprosy, diarrhoea) and
increased risks of measles, whooping cough and jaundice
epidemics. The paper focuses on the way in which how
these medical assessments became part of the logic of
counter-subversion, and how they influenced the path-
ways of ongoing resettlement schemes.
In the paper ‘Chronic political instability and the imple-
mentation of the HIV-AIDS response in Guinea-Bissau: a
case study of the intersections of politics and epidemiol-
ogy (2000-2015)’ Josh Galjour (University of Geneva/
Global Fund, Geneva) gives an account of the situation
in Guinea-Bissau regarding HIV/AIDS. In contrast to
most of its West African neighbors where HIV/AIDS
rates have remained low, HIV/AIDS remains a major
public health problem, being second most common
cause of death in Guinea-Bissau. Guinea Bissau is a small
country on the West African coast, with approximately
1.8 million inhabitants. Once a Portuguese colony un-
til gaining independence in 1974, it is today one of the
world’s poorest countries. In addition, Guinea-Bissau is
also one of the most fragile states, plagued by chronic
political instability, and its health indicators are among
the worst in the world. Guinea-Bissau’s chronic politi-
cal instability - vis-à-vis its neighboring countries with
lower HIV/AIDS prevalence - begs the question whether
this circumstance may somehow be related to its higher
prevalence and the country’s weaker performance on
key coverage indicators. From 2000 to 2015, Senegal,
The Gambia, and Guinea have all been relatively stable
or have experienced relatively isolated periods of politi-
cal instability or uncertainty when compared to Guinea-
Bissau. The author’s PhD research applies an interdisci-
plinary approach, drawing on the fields of public health,
political economy, and public finance and administration.
The analysis of quantitative and qualitative data, shows
for the period from 2000 to 2015, chronic political insta-
bility characterized by frequent
coup d’états
and changes
in leadership in key government health positions served
as major barriers to an effective HIV/AIDS response in
Guinea-Bissau.
3.4.
The Entanglement of Colonial
andTropical Medicine
In the fourth session, Isabel Amaral (CIUHCT-UNL) dis-
cussed the role of ‘Portuguese physicians overseas and
the consolidation of tropical medicine in the twentieth
century: case study of Rafael António de Sousa Caixeiro
(1923-1990)’.The author addressed the power relation-
ships entertained by the second generation of physicians
who received military and civil training inAfrica and Lis-
bon and were committed to the consolidation of tropical
medicine.The paper traces the career of Rafael António
Caixeiro, a so far unknown physician in Portuguese histo-
riography, based upon the study of his personal archive.
Specializing in sanitary hygiene, tropical medicine, soci-
ology and anthropology, he pursued a military career af-
ter the SecondWorldWar, like many other physicians in
empire, visiting CaboVerde, Guinea, Macao and Angola.
Returning to Lisbon in 1969 as a medical colonel, he
taught military and tropical hygiene at the
Escola de Serviço
de Saúde Militar
and at the
Escola Nacional de Saúde Pública
e Medicina Tropical
(ENSPMT) respectively, defending his
PhD dissertation at the IHMT in 1980.The professional