(5) STDs provoked a unique emotional reaction because they combined both sin and innocent victims, congenital syphilis being held responsible for Uganda's high miscarriage, stillbirth and infant mortality rates. Thus in 1918 the governor reported that the immense mortality caused by recent epidemics of plague, smallpox, measles and meningitis was 'to be expected', whereas the 'deep-rooted injury to the people from venereal diseases is of infinitely greater gravity', even though they accounted for only a fraction of all deaths.

(4) This radical system appealed to the doctors because of its efficiency, but was supported by administrators because of their concerns about both moral and population decline. The attraction of these procedures to the military clinicians was that they freed the 'patient of all participation in his treatment and the medical officer is independent of his assistance'. Chiefs were paid to report suspected cases, entire villages were rounded up to be examined for syphilis, and patients overdue for an injection of mercury were forced to attend the clinic by the police. Over the following years a structure of STD control was established which provided a greater degree of compulsion than could be found anywhere else in the world. (3) Given that it was the missions that provided the bulk of healthcare in the Protectorate, the colonial administration quickly mollified the local religious establishment, by agreeing to support 'social purity' campaigns, while recruiting a number of RAMC officers to begin a programme of treatment. Missionaries in response blamed social disintegration and degeneration on the colonial government's system of taxation and legal reforms, which, they argued, undermined marriage. An expert in syphilis, Colonel Lambkin of the Royal Army Medical Corps (RAMC), was drafted in, and reported that the disease was indeed hugely prevalent, but that it was Christianity itself which had weakened local norms of morality, by liberating women from traditional patriarchal controls. Missionary doctors believed that the Ganda's low fertility and high child mortality were due to an epidemic of syphilis, which they claimed infected 80 per cent of the population over their lifetime. The story begins in 1907 in Buganda when local missionary fears that the Ganda ethnic group were in danger of becoming extinct won the attention of the colonial governor. It will do so by examining the practice and legacy of colonial STD campaigns in Buganda in southern Uganda. (2) This paper will argue that India was not an exception to the rule, and that imperial welfarism was neither monolithic nor invariably illiberal. Yet the introduction of the Contagious Diseases and Military Cantonments Acts in late 19th-century India provoked a storm of controversy, locally and in the metropolis, resulting in an STD policy that was characterised above all by inconsistency. Given the reputation of colonial rule for illiberalism and a fixation with physical security, one would expect that interventions aimed at preventing the spread of STDs within the British empire would have tended towards the more coercive end of the welfarist spectrum. Moreover, there has usually existed an easily definable scapegoat, in the form of commercial sex workers, on whom moral responsibility can be placed and compulsory medical examinations and treatment targeted. Sexually-transmitted diseases (STDs) are often associated with welfarist interventions of an unusually authoritarian nature, because they particularly threaten both the integrity of the family and the efficacy of the armed forces. Welfare reform is typically motivated by some combination of altruism and a desire for greater social control.

STDs and welfare in East Africa Shane Doyle, University of Leeds (1)

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