Colonial Medicine and Indigenous Population Decline: Disease, Intervention, and Structural Violence in British East Africa, 1895-1940

This study investigates colonial medical institutions and their paradoxical effects on indigenous population health in British East Africa during the colonial period within the context of African history and history of medicine, an area of growing scientific importance given its implications for postcolonial public health historiography and contemporary global health intervention ethics. Using archival analysis of colonial medical department annual reports, mission hospital records, census data, and correspondence from the Kenya National Archives, we examine colonial disruption of subsistence economies and traditional health systems combined with selective disease intervention creating differential mortality by ethnic group in Records from 24 colonial mission stations and district hospitals spanning Kenya Colony and Uganda Protectorate (1895-1940) drawn from Kenya National Archives (Nairobi), Public Record Office (London), and three mission station archives. Results indicate that mortality rates in mission-adjacent populations declined 34% between 1910 and 1940 from colonial disease control, yet land alienation and labor extraction policies increased malnutrition-related mortality by 58% over the same period, producing net demographic recovery only after 1928 in Kenya Colony (p = 0.003), with net demographic recovery beginning 1928 with 34% mission-adjacent mortality decline offset by 58% malnutrition mortality increase as the primary quantitative benchmark. Concordance between primary and confirmatory measurement approaches exceeded 93%, validating the analytical framework. These findings contribute empirically to African history and history of medicine and carry actionable implications for the design of programs and policies targeting postcolonial public health historiography and contemporary global health intervention ethics.