Nothing was more important for the medical staff than urban sanitation. However, there was a shortage of medical staff in the country. Only Berbera had one Indian sanitation officer. In the other towns, sanitation was under the control of district officers, while medical officers assisted with technical advice and routine inspections. In general, the sanitation system of the towns was undeveloped. Even the European quarters in all the towns, except Berbera, used the bucket system for the disposal of sewage. In other words, the towns lacked pit-latrines and so the medical staff established defecation areas outside the towns. Water supplies were also not developed in the towns. Pumps were established in Burao, Sheikh, Hargeysa and Berbera by 1936 (Sanitary Report, 1936). These services, however, were only for Europeans. The local population drew its water supplies from wells. Although the sanitary system was weak, the medical staff still managed to perform myriad public health functions. They inspected the towns, played a key role in town-planning in Burao and Odweina, detained cases considered a health hazard to the public, established defecating boundaries outside the towns, controlled venereal diseases and tuberculosis and disseminated ideas to the public about safe methods of disposing of garbage and conserving water in their homes. The district commissioners played a key role in that process. Rayne (1921, pp. 28±29) who was the district commissioner of Zeila in the early 1920s, stated that every morning

I wander through the streets and note that the sweepers are doing their work in keeping the town clean. If the environment of a house are found to be in a filthy state, this happens seldom, I just say: “Tell the owner to come to the office”. This means that he is “for it” later on the day. We do not argue about such matters in the street.

The campaign against the spread of diseases was also waged at the level of public discourses in both the towns and the rural areas and particularly, in the relief camps. This was, however, a primitive form of discourse. In the towns, the medical staff used interconnected loudspeakers (or what Somali called `wadhacwadhac’, a metonym for the noise the loudspeakers made) in various locals in which notices, ordinances, and policies were announced. The campaign was more effective in the relief camps where the medical staff had direct access to the inmates of the camps on a daily basis. The medical department established a permanent camp for the elderly poor and orphans at Berbera in 1930. However, the first relief camp was opened at Berbera in 1918 as a result of the 1918 drought. Another relief was opened at Bulhar in 1927 and closed in 1930. The camp was opened in response to the severe drought that affected the country in from 1927 to 1930 (Relief Report, 1929). The department organized other relief camps in 1933, 1934 and 1936 (Colonial Office Report, 1933, 1934, 1936). In all the camps, the medical staff always gave the inmates public health education lectures, vaccinated them against smallpox and other diseases. In 1929, for instance, all the inmates at the Bulhar relief camp were inoculated against smallpox (Relief Report, 1929).


Moreover, public health educational measures were extended to rural areas, with particular emphasis on the control of malaria epidemics. The 1936 medical report, for instance, called for the need to educate the people and energetically distribute quinine, in response to the new malaria epidemic in the 1930s, especially the 1935±1936 epidemic. P. Granville Edge, the Principle Medical Officer, believed that the campaign would not succeed. As he sarcastically put it, the people have not yet “learned that quinine will cure the disease much more effectively than the prayers of a mullah or a Koranic amulet strung around the neck” (Edge, 1938, p. 535). Edge, however, was unaware of the fact that the people’s attitude towards medicine was pluralistic (Janzen, 1978; Frierman, 1979; Ahmed, 1988; Greco and Antoniotto, 1988; Krenawi et al., 1996). They never just relied on an amulet for treatment. In general, they distinguished between various ailments: diseases such as malaria or smallpox, evil eye, and mental illness. Hence the specialization of the different healers. Abdullahi Mohamed Ahmed classified six different healers and seven different forms of traditional therapy (Ahmed, 1988, pp. 240±242). The issue cannot be discussed in detail here, it suffices to say, that the people’s attitude towards healing was pluralistic. They moved from professional modern medical practices to traditional practices. They even moved between traditional systems of healing.

As already pointed out, people were not always hostile to medical advice. This was demonstrated by their receptive attitude towards medicine against venereal diseases and relapsing fever, in the towns. It appears that they judged medical advice on pragmatic criteria – on its efficiency. However with respect to medical advice against malaria, that criteria was often not fulfilled, because the disease was seasonal and hence required prompt response. Indeed, malaria required preventive action and in particular, the consumption of quinine before the infection.

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