The Colonial Medicine of Settler States: Comparing Histories of Indigenous Health

Author(s): Warwick Anderson

Source: Health and History , 2007, Vol. 9, No. 2, Aboriginal Health and History (2007),
pp. 144-154
Published by: Australian and New Zealand Society of the History of Medicine, Inc

Stable URL: https://www.jstor.org/stable/40111579

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The Colonial Medicine of Settler
States: Comparing Histories of
Indigenous Health

Warwick Anderson

The history of Indigenous health connects inextricably with

matters of geography and colonisation. 'Indigenous' usually
connotes a place, often figured as marginal or isolated or
developmental - as somewhere else.1 More pertinently,
Indigenous status implies - or rather, is predicated upon - a
history of colonisation and dispossession, with consequent
resistance and adaptation to invaders and settlers. The term
marks the contrast between original inhabitants and colonisers.
The effort to identify some special Indigenous essence or type
ultimately is futile since the status emerges out of political
subordination under settler colonialism.2 The history of
Indigenous health thus demands sensitivity to the impact of both
colonialism and the incipient white nation-state. Moreover,
it requires a critical awareness of the dark sides of contact,
'civilisation,' and 'development,' as well as an appreciation of
the multiple implications of the related processes of assimilation,
integration, and self-determination.3
Since first contact with European invaders, Indigenous
people on the whole have been sicker and died younger than
non-Indigenous inhabitants of the same colony or state.4 These
health disparities have lessened significantly in North America
and New Zealand, but remain severe across Australia.5 During
the late-twentieth century, some historians attempted to explain
the initial colonial impact on Indigenous societies in biological
terms. Thus infectious diseases swelled the 'ranks of death,' as
Indigenous people suffered 'virgin-soil' epidemics, the natural
result of 'ecological imperialism.'6 As most of these historians
later conceded, such biological analysis tended to discount the
unnatural effects of warfare, dispossession, and demoralisation
on health and social organisation.7 Biological explanations of
contemporary health disparities are largely out of fashion - the

1 44 Health & History, 2007. 9/2

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 Comparing Histories of Indigenous Health 145

'thrifty gene' hypothesis notwithstanding.8 Rather, historians

of continuing Indigenous illness and disability now are more
likely to address the lasting effects of racial discrimination,
dispossession, family disruption, poverty, social marginalisation,
and limited access to health care. As Mick Dodson reported to
the United Nations Working Group on Indigenous Populations:
'We are all part of the world community of Indigenous peoples
spanning the planet, experiencing the same problems and
struggling against the same alienation, marginalisation, and
sense of powerlessness.'9
Just as attitudes toward the causation of Indigenous
illness and death have changed, so have proposed solutions to
health disadvantage varied over time. When Europeans moved
into Australasia and North America, they frequently represented
the original inhabitants as primitive nomads rambling over
isolated yet strangely desirable territory. Indigenous people
thus were cast as feckless, immature, and vulnerable. For
some observers they were a dying or 'doomed' race, requiring
only some perfunctory palliation of their passing.10 Others
eventually recognised the potential - especially of those of
mixed ancestry - for assimilation into the predominantly white
national community so that problems of Indigenous health
should gradually dwindle into ordinary problems of proletarian
health.11 More recently, policies of 'self-determination' have
allowed some Indigenous people to influence the framing of
their communities' health problems and to participate actively
in responding to their distinctive challenges of illness and
disability. Yet it remains difficult for any settler society to invest
seriously in people whose continuing existence etches in clear
relief the illegitimacy and violence of the state. Settler states are
more comfortable intervening to correct health disparities the
more readily they recognise sufferers as similar to ordinary white
citizens. While self-determination efforts assert difference and
independence, and thus generally meet with state indifference
or hostility, assimilation policies permit some basic civic
recognition, thus demanding larger financial commitment and
political attention from national leaders. Unfortunately, it seems
even the illusion of autonomy is incompatible with delivery of
government services.

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146 WARWICK ANDERSON

Aboriginal Australian health became a distinct historical

issue in the 1970s during the period of self-determination.
Before that, it was subsumed in accounts of contact and
assimilation, or employed as colourful backdrop to medical
biography, or lost in a sad footnote to the history of medicine
in white Australia. Not surprisingly, anthropologists led efforts
to situate more traditional Aboriginal ideas about illness in their
proper social and historical context. When Janice Reid began
her study of Yolngu health beliefs in 1974, it soon became
clear that without carefully considering the history of contact
with outsiders, notions of resilience, continuity, and change
in disease explanation had little meaning.12 Later, as co-editor
of a collection of essays on the health of Aboriginal Australia,
Reid made sure to commission an historical introduction to the
subject.13
In their historical essay, Margaret-Ann Franklin and
Isobel White provided a pioneering overview of the decline
of Australian Aboriginal health, emphasising the influence of
frontier violence, dispossession, herding onto reserves and
missions, poor nutrition, and medical neglect. Assimilation
policies after World War II had finally prompted investigation of
the health conditions of outback reserves and missions, leading
belatedly to recognition of the deplorably high Aboriginal infant
mortality rate. In the 1960s and 1970s, some medical doctors,
such as Archie Kalokerinos at Collarenebri and Max Kamien
at Bourke, forcefully drew attention to the high prevalence of
preventable disease in Aboriginal communities. After the 1967
referendum gave the Commonwealth government authority
to legislate for Aboriginal Australians, federal funding for
Indigenous health expanded, with white administrators and
medical personnel initially controlling most projects. Many of
them still were committed to preparing their charges for eventual
assimilation. Then in 1973 the Labor government declared
Aboriginal Australians to be distinct culturally and that they
deserved the opportunity to determine their own future. In part,
this represented a response to widespread Aboriginal activism,
focusing on land rights and self-determination, and sometimes
echoing the campaigns of the Black and Red Power movements
in the United States of America.14 In 1991, Franklin and White
concluded their survey hopefully, asserting there were 'signs
that some whites in the community and government may be

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 Comparing Histories of Indigenous Health 147

learning from Aborigines what Aborigines want and need, and

acknowledging that local autonomy is crucial to the process of
self-determination and self-management.'15 But even when the
policy of self-determination briefly flourished it never accrued
the resources necessary for success. In any case, this period of
respect for Aboriginal involvement would prove disappointingly
evanescent.

More recently, even with the waning of self-

determination, a few Australian historians have returned to the
study of Aboriginal health. Notably, Gordon Briscoe examines
critically the development between 1900 and 1940 of medical
services for the Indigenous inhabitants of Queensland and
Western Australia. The comparison is apt, since Queensland
was perhaps the most segregated of the states while authorities
in the west strongly favored assimilation. The priority in both
places was to prevent the spread of Aboriginal disease into white
communities: in Queensland this generally meant isolating and
limiting the mobility of Indigenous people, yet at the same
time in Western Australia it led to efforts to produce a dusky
proletariat.16
While Briscoe gives us a valuable demographic and
institutional history of Aboriginal health and illness, others
have taken up the study of medical discourses on Aboriginality.
In Reading Doctors ' Writing, David Piers Thomas conducts a
detailed and telling analysis of the representation of Aboriginal
Australians in the MedicalJournal of Australia (MJA) between
the 1870s, when they appear as a doomed race, and the late
1960s, when the term 'Aboriginal health' is coined. Displaying
the influence of Michel Foucault and Edward W. Said, Thomas
argues that research on Aboriginal people for most of this period
was 'entangled with the politics of colonialism.'17 Although
Thomas's study inevitably repeats much of the conventional
history of ideas about Aborigines generated by physical
anthropologists and human biologists (most of whom boasted
medical qualifications), his book importantly illuminates the
contributions of white medical activists. Many of these, like
Barry Christophers, were affiliated with the Communist Party,
and from the 1950s were agitating the letters pages of the MJA
with demands for better Indigenous health services.18
Historians across the Tasman have documented the
development of Indigenous health services more extensively

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1 48 WARWICK ANDERSON

than their Australian counterparts. Raeburn Lange, for example,

provides us with a richly contextualised social history of Maori
and government initiatives in public health during the early
twentieth century.19 Although in Maori Health and Government
Policy Derek A. Dow deliberately focuses more narrowly on
policy formulation, he adds nuance and detail to many of the
technical issues that are less important in Lange 's history.20
Dow argues that there was more Pakeha (non-Indigenous
New Zealander) concern for Maori health - and more Pakeha
efforts to improve it - before 1900 than is generally assumed. In
contrast, Lange seeks a usable history of Maori-led community
development and health work, a story of Maori initiative and
innovation. Indeed, to an outsider the most striking feature
of the history of Indigenous health efforts in New Zealand
is the involvement, and indeed dominance, of Maori doctors
and community activists. It is, as Lange points out, an early
example - perhaps the first - of Indigenous health work
designed and directed by Indigenous people. Maui Pomare,
who graduated from a missionary medical college in Chicago in
1 896, led the public health work, and in 1923 became minister of
health. A brilliant scholar, Peter Buck (Te Rangi Hiroa) received
his medical degree from Otago in 1900, and later became the
head of the division of Maori hygiene in the health department
before he turned to the study of Pacific anthropology. Also in
Buck's medical cohort was Tutere Wi Repa, a somewhat erratic
promoter of community health work during this period.
The contrast with Australia is stunning. For example, it was
not until the 1980s that an Aboriginal Australian graduated in
medicine. Unfortunately, neither Lange nor Dow suggests why
New Zealand was so much more advanced. Lange perhaps comes
closest to an explanation when he discusses the influence of the
denominational boarding schools, especially Te Aute College,
which in the 1 890s provided a secondary education for the first
generation of Maori doctors and lawyers, and gave rise to the
Young Maori Party. It may be that this institutional accessibility
has something to do with the small scale of the New Zealand social
world, the persisting strength of many Maori communities, and
an unusually liberal polity that allowed both Maori and women
to vote. Whatever the explanation for their dramatic arrival on
the scene, Pomare and Buck and others set about improving
Maori hygiene and living conditions with a special sensitivity

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 Comparing Histories of Indigenous Health 149

and insight that derived from their own Maori background. In

a somewhat presentist fashion, Lange argues that these Maori
doctors were engaging in 'community development,' treating
communities as 'partners,' and using their 'communication
skills' to urge health reform - that is, they were precursors of
self-determination in Indigenous health work.
Australian scholars will find the history of Indigenous
health development in North America more depressingly
familiar, even if USA policies anticipate Australian ones by at
least a generation and the usual oscillation between assimilation
and self-determination varies. Treaty obligations meant that
American Indians received some perfunctory health care from
the early nineteenth century, but it was not until John Collier,
a social reformer from New York, became Commissioner of
Indian Affairs in 1933 that Indigenous health was recognised
as a major problem for the federal government. Collier initiated
the 'Indian New Deal', promising conservation of Indigenous
culture and resources, with protection of Indigenous health.21
Yet after World War II, the Commission on Reorganisation of the
Executive Branch of the Government, led by former president
Herbert Hoover, recommended integration of Indians into
the general population and the 'termination' of special status.
During the 1950s, the Republican administration promoted
assimilation, withdrawing recognition of tribes, moving
families from reservations to cities, and closing the Bureau of
Indian Affairs. Other 'mainstream' government agencies took
up responsibilities for Indigenous affairs. The Indian Health
Service, a section of the Public Health Service dominated by
white professionals, became the sole national health program
for civilians in the USA. Throughout the 1960s, however, critics
were demanding more community control and decentralisation
of the health service and the training and hiring of more Indian
doctors. To meet many of these demands, President Richard
M. Nixon confirmed and endorsed in 1970 the drift toward
a policy of 'self-determination'. But as in other examples
of self-determination, community health programs never
received adequate funding or support, and under the Clinton
administration they were cut severely. Nevertheless, indices of
Indigenous morbidity and mortality steadily improved in the
USA during the post-war period.22

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1 50 WARWICK ANDERSON

The improvement in the health status of Canadian First

Nations is also striking, although as elsewhere disparity with
non-Indigenous health continues to prevail. Mary-Ellen Kelm
describes the misery and resilience of the colonised Aboriginal
people of British Columbia before World War II, their poor
nutrition, social disruption, and the ravages of tuberculosis,
which was rife in the reservations and boarding schools.23
Yet the 1940s marked a shift toward a larger federal role in
ameliorating Indigenous conditions. In 1945, the Indian and
Eskimo Health Services were transferred from Indian Affairs,
part of the federal Department of Mines and Resources, to the
Department of National Health and Welfare. As in the USA,
federal services expanded in order to prepare Indigenous people
for more efficient integration into the nation-state. Similarly,
government commitment north of the border provided the
resources and opportunities for greater Indigenous self-assertion
during the 1 960s, leading, perhaps ironically, to opposition to
assimilation and demands for self-determination.24 As Kelm
points out, there has always been a 'tradition of active and
engaged response to the processes of colonisation that seeks
to subvert those processes and reshape Aboriginal destinies in
ways that are independent of the Canadian government.'25
The diversity of Indigenous experience and the patchiness of
historical analysis defy any simple transnational comparison of
health development.26 Certain themes and patterns and common
points of reference do emerge however. The devastating
impact of dispossession, discrimination, alienation and poverty
under settler capitalism is obvious. So too are the salience of
Aboriginal activism and leadership, and the importance of
national commitment to improving Indigenous health. Australia,
the country tainted with the worst health disparities, is also
historically exceptional, having failed to confer any special
status on Indigenous people, avoiding any treaties, and only
belatedly allowing national action or intervention. Additionally,
the common association of assimilation with government
intervention and investment, contrasting with the government
neglect and indifference that self-determination often licenses,
is evident at multiple sites. That is, it appears government action
on health improvement is linked to civic recognition in the
nation-state, to probationary forms of social citizenship - while

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 Comparing Histories of Indigenous Health 151

Indigenous community control or autonomy may deflect national

interest.27 Put bluntly, you can have 'culture' or government
health services, but not both.
Persistent colonial relations have characterised Indigenous
health, although few historians have directly addressed this
durable imperial logic.28 Strikingly, both Kelm and Thomas frame
their historical analysis in terms of colonial medicine, reading
representations of Indigenous people as colonial discourse,
or showing how the colonising state impinged intimately on
Indigenous bodies and social lives. But Kelm's meticulous
attention to the affective, personal aspects of Aboriginal health
care, to the more private consequences of colonial medicine,
is still rare. We need more stories telling us about Indigenous
health as a structure of feeling and as a moral sensibility.29 The
field of Indigenous mental health may provide especially fertile
ground for further study of the blighted intimacy of colonial
power.30
Although historians of medicine have just begun to focus on
Indigenous health, the contemporary health care of Aboriginal
peoples is already thoroughly historicised. 'History' figures
in most arguments about Indigenous health policy. Indeed,
discussion of Indigenous health is now one of the few ways for
historical narrative ever to gain entry to medical journals. As more
historians take advantage of this unique permit system, a more
richly contextualised and comparative history of Indigenous
health might come to inform and shape contemporary debate.

University of Sydney

Acknowledgment
1 am grateful to Ian Anderson and Emma Kowal for their suggestions and
comments on an earlier draft of this essay.

1 . Mary Jane McCallum, "This Last Frontier: Isolation and Aboriginal Health,"
Canadian Bulletin of the History of Medicine, vol. 22 (2005): 103-20.
2. But see Chris Cunningham and Fiona Stanley, "Indigenous by Definition,
Experience, or World View/' British Medical Journal, vol. 327 (2005): 403-4.
3. Tim Rowse, ed., Contesting Assimilation (Perth, WA: API Network, 2005).
4. Stephen Kunitz, Disease and Social Diversity: The European Impact on the
Health of Non-Europeans (New York: Oxford University Press, 1994).

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1 52 WARWICK ANDERSON

5. Robin Fisher, "The Impact of European Settlement on the Indigenous Peoples

of Australia, New Zealand, and British Columbia: Some Comparative Dimensions,"
Canadian Ethnic Studies, vol. 12 (1980): 1-13; David E. Stannard, "Disease and
Infertility: A Look at the Demographic Collapse of Native Populations in the Wake
of Western Contact," Journal of American Studies, vol. 24 (1990): 325-50; and Ian
Anderson, Sue Crengle, Martina Leialoha Kamaka, Tai-Ho Chen, Neal Palafox, Lisa
Jackson-Pulver "Indigenous Health in Australia, New Zealand, and the Pacific,"
Lancet, vol. 367 (2006): 1775-85. In this essay I focus on the major predominantly
Anglophone settler societies, where the specific history of Indigenous health has been
most readily recognised, though a more comprehensive survey should include the health
of Indigenous peoples in other parts of the world, including the rest of the Americas.
6. Percy M. Ashburn, The Ranks of Death: A Medical History of the Conquest
of America (New York: Coward-McCann, 1947); William H. McNeill, Plagues and
Peoples (New York: Anchor Books, 1977); Alfred W. Crosby, "Virgin Soil Epidemics as
a Factor in the Aboriginal Depopulation in America," William and Mary Quarterly, vol.
33 (1976): 289-99. See also Judy Campbell, Invisible Invaders: Smallpox and Other
Diseases in Aboriginal Australia. 1780-1880 (Melbourne, Vic: Melbourne University
Press, 2002).
7. David S. Jones, "Virgin soils revisited," William and Mary Quarterly, vol. 60
(2003): 703-42.
8. Margery Fee, "Racializing Narratives: Obesity, Diabetes, and the 'Aboriginal'
Thrifty Genotype," Social Science and Medicine, vol. 62 (2006): 2988-997; and Yin
C. Paradies, Michael J. Montoya, and Stephanie M. Fullerton, "Racialized Genetics
and the Study of Complex Diseases: The Thrifty Genotype Revisited," Perspectives in
Biology and Medicine, vol. 50 (2007): 203-27. See also Philip D. Curtin, "The Slavery
Hypothesis for Hypertension among African Americans: The Historical Evidence,"
American Journal of Public Health, vol. 82 (1992): 1681-86.
9. Mick Dodson, "Linking International Standards with Contemporary Concerns
of Aboriginal and Torres Strait Islander Peoples," in Indigenous Peoples, the United
Nations and Human Rights, edited by Sarah Prichard (London: Zed Books, 1995),
19, quoted in Stephen J. Kunitz, "Globalization, States, and the Health of Indigenous
Peoples," American Journal of Public Health vol. 90 (2000): 1531-1539, 1537.
10. Frederick L. Hoffman, "Are the Indians Dying Out?" American Journal
of Public Health, vol. 20, no. 6 (1930): 609-14; Daisy Bates, The Passing of the
Aborigines: A Lifetime Spent Among the Natives of Australia (London: Murray, 1947);
and Russell McGregor, Imagined Destinies: Aboriginal Australians and the Doomed
Race Theory, 1880-1939 (Melbourne, Vic: Melbourne University Press, 1997). See
also Caitlin Murray, "The 'Colouring' of the Psychosis: Interpreting Insanity in the
Primitive Mind," Health and History, this issue.
11. I make this point in Warwick Anderson, The Cultivation of Whiteness: Science.
Health and Racial Destinv in Australia (Melbourne, Vic: Melbourne University Press,
2002).
12. Janice Reid, Sorcerers and Healing Spirits: Continuity and Change in an
Aboriginal Medical System (Canberra, ACT: Australian National University Press,
1983). See also William E.H. Stanner, "Some Aspects of Aboriginal Health," in Better
Health for Aborigines: Report of a National Seminar at Monash University, edited by
B.S. Hetzel, M. Dobbin, L. Lippman, and E. Eggleston (St Lucia, Qld.: University of
Queensland Press, 1974), 3-13.
13. Janice Reid and Peggy Trompf, eds, The Health of Aboriginal Australia
(Sydney, NSW: Harcourt Brace, 1991). See also Ernest Hunter, Aboriginal Health
and History: Power and Prejudice in Remote Australia (Melbourne, Vic: Cambridge
University Press, 1993).
14. For example, the Aboriginal Medical Service established in Redfern in 1971
was modeled on the Black Panther Party's health centres - it became the progenitor
of many more community-controlled Aboriginal health services. See Kathy Lothian,
"Seizing the Time: Australian Aborigines and the Influence of the Black Panther

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 Comparing Histories of Indigenous Health 153

Party, 1969-1972," Journal of Black Studies, vol. 35 (2005): 179^200. Of course, in

acknowledging the impact of the Black Panthers 1 do not mean to diminish Aboriginal
agency in these developments or to deny many other influences on activists in the
1960s and 1970s, including global anti-colonial movements. On the situation in central
Australia see Clive Rosewarne, Petronella Vaarzon-Morel, Stephanie Bell, Elizabeth
Carter, Margaret Liddle and Johnny Liddle, "The Historical Context of Developing an
Aboriginal Community-Controlled Health Service: A Social History of the First Ten
Years of the Central Australian Congress," Health and History, this issue.
15. Margaret- Ann Franklin and Isobel White, "The History and Politics of
Aboriginal Health," in Health of Aboriginal Australia, edited by Janice Reid and Peggy
Trompf (Sydney, NSW: Harcourt Brace Jovanovich, 1991), 1-36, 33.
1 6. Gordon Briscoe, Counting, Health and Identity: A History of Aboriginal Health
and Demography in Western Australia and Queensland, 1900-1940 (Canberra, ACT:
Aboriginal Studies Press, 2003). For Queensland, see also Ross Patrick, A History
of Health and Medicine in Queensland, 1824-1960 (St Lucia, Qld.: University of
Queensland Press, 1987); Rosalind Kidd, The Way We Civilise: Aboriginal Affairs -
The Untold Story (St Lucia, Qld.: University of Queensland Press, 1997); and Leonie
Cox. "Fear, Trust and Aborigines: The Historical Experience of State Institutions and
Current Encounters in the Health System," Health and History, this issue. On Western
Australia, see also Brian McCoy, "'They Weren't Separated': Missions, Dormitories,
and Generational Health," Health and History, this issue. On the Northern Territory,
see Suzanne Saunders, Disease Medicine, and Settlement: The Role of Health and
Medical Services in the Settlement of the Northern Territory, PhD thesis, University
of Queensland, 1992, and "'A Duly Qualified Medical Practitioner': Health Services in
the Northern Territory, 191 1-39," in Peripheral Visions: Essays on Australian Regional
and Local History, edited by Brian J. Dalton (Townsville, Qld.: James Cook University
Press, 1991), 251-67; and Lindsey Harrison, "Government Policy and the Health Status
of Aboriginal Australians in the Northern Territory, 1945-72," in Migrants, Minorities
and Health: Historical and Contemporary Studies, edited by Lara Marks and Michael
Worboys (London: Routledge, 1997), 125^6.
17. David Piers Thomas, Reading Doctors' Writing: Race, Politics and Power in
Indigenous Health Research. 1870-1969 (Canberra, ACT: Aboriginal Studies Press,
2004), 136.
18. On the physical or biological anthropologists, see also McGregor, Imagined
Destinies, and Anderson, Cultivation of Whiteness. I have not discussed here at length
the history of Aboriginal Australians as biological research subjects, choosing instead to
concentrate on the later historical recognition of Aboriginal illness and the development
of health services, though the availability of Aboriginal bodies for research purposes,
along with the contemporary lack of interest in their health, arguably is part of the
history of Indigenous health care.
1 9. Raeburn Lange, May the People Live: A History of Maori Health Development,
1900-1920 (Auckland: Auckland University Press, 1999). See also Mason H. Durie,
Whaiora: Maori Health Development (Auckland: Oxford University Press, 1994).
20. Derek A. Dow, Maori Health and Government Policy 1840-1940 (Wellington:
Victoria University Press, 1999). See also his Safeguarding the Public Health: A
History of the New Zealand Department of Health (Wellington: Victoria University
Press, 1995). Linda Bryder and Derek A. Dow edited a Maori health special issue of
Health and History, vol. 3, no. 1 (2001) - their "Introduction: Maori Health History,
Past. Present and Future" is especially pertinent.
2 1 . Lawrence C. Kelly, The Assault on Assimilation: John Collier and the Origins
of Indian Policy Reform (Albuquerque, NM: University of New Mexico Press, 1983).
For a detailed account of the effect of national policy on the actual delivery of care and
preventive efforts, see David S. Jones, Rationalizing Epidemics: Meanings and Uses of
American Indian Mortality Since 1600 (Cambridge: Harvard University Press, 2004). See
also Stephen J. Kunitz and Jerrold E. Levy, "Dances with Doctors: Navajo Encounters

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1 54 WARWICK ANDERSON

with the Indian Health Service," in Western Medicine as Contested Knowledge, edited
by Andrew Cunningham and Bridie Andrews (Manchester: Manchester University
Press, 1997), 95-104.
22. Stephen J. Kunitz, "The History and Politics of U.S. Health Care Policy for
American Indians and Alaskan Natives," American Journal of Public Health, vol. 86
(1996): 1464-73; and Christopher K. Riggs, "The Irony of American Indian Health
Care: The Pueblos, the Five Tribes, and Self-Determination, 1954-1968," American
Indian Culture and Research Journal, vol. 4 ( 1 999): 1-22.
23 . Mary-Ellen Kelm, Colonizing Bodies: Aboriginal Health and Healing in British
Columbia. 1900-50 (Vancouver, BC: University of British Columbia Press, 1998). For
Manitoba, see Paul Hackett, "From Past to Present: Understanding First Nations Health
Patterns in a Historical Context," Canadian Journal of Public Health, vol. 96 (2005):
S17-S21. See also James B. Waldram, D. Ann Herring, and T. Kue Young, Aboriginal
Health in Canada: Historical, Cultural, and Epidemiological Perspectives (Toronto,
Ont: University of Toronto Press, 1995); and Maureen K. Lux, Medicine that Walks:
Disease, Medicine and Canadian Plains Native People, 1880-1940 (Toronto, Ont:
University of Toronto Press, 2001).
24. Kelm, Colonizing Bodies: and McCallum, "This last frontier."
25. Kelm, Colonizing Bodies, p. 1 78.
26. For preliminary explorations, see Kunitz, Disease and Social Diversity',
Stephen Kunitz and Maggie Brady, "Health Care Policy for Aboriginal Australians: The
Relevance of the American Indian Experience," Australian Journal of Public Health,
vol. 19 (1995): 549-58; and Kunitz, "Globalization." In the last essay, Kunitz claims that
globalisation "may provide part of an answer to the destruction that states have visited
upon Indigenous peoples" (p. 1538). Clearly, before we can achieve any satisfactory
comparison of histories of Indigenous health we will need more national histories
dealing with the late-twentieth century and an effort to encompass other Indigenous
histories, including those of the peoples of Latin America and Asia.
27. On biomedical citizenship in the liberal colonial state, see Warwick Anderson,
Colonial Pathologies: American Tropical Medicine, Race, and Hygiene in the
Philippines (Durham, NC: Duke University Press, 2006).
28. See Linda Tuhiwai Smith, Decolonizing Methodologies: Research and
Indigenous Peoples (London: Zed Books, 1999).
29. On moral sensibilities, see Clifford Geertz, "Found in Translation: On the
Social History of the Moral Imagination," in Local Knowledge: Further Essays in
Interpretive Anthropology (New York: Basic Books, 1983), 36-54. On structures of
feeling, see Raymond Williams, Marxism and Literature (Oxford: Oxford University
Press, 1977). This suggestion reflects some of the more programmatic statements in
Ann L. Stoler, ed., Haunted by Empire: Geographies of Intimacy in North American
History (Durham, NC: Duke University Press, 2006). For a particularly compelling
account, see Bronwyn Fredericks, "Australian Aboriginal Women's Health: Reflecting
on the Past and Present," Health and History, this issue.
30. On the development of Aboriginal mental health more generally, see Edmund
McMahon, "Psychiatry at the Frontier: Surveying Aboriginal Mental Health in the Era
of Assimilation," Health and History, this issue.

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