Working Paper: CEPR ID: DP12772
Authors: Sara Lowes; Eduardo Montero
Abstract: Between 1921 and 1956, French colonial governments organized medical campaigns to treat and prevent sleeping sickness. Villagers were forcibly examined and injected with medications with severe, sometimes fatal, side effects. We digitized thirty years of archival records to document the locations of campaign visits at a granular geographic level for five central African countries. We find that greater historical exposure to the campaigns reduces trust in medicine – measured by willingness to consent to a free, non-invasive blood test. The resulting mistrust is specific to the medical sector. We examine relevance for present day health initiatives; we find that World Bank projects in the health sector are less successful in areas with greater exposure to the campaigns.
Keywords: trust; medicine; colonialism; health; culture
JEL Codes: N37; I15; I18; O55; Z13
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Greater historical exposure to colonial medical campaigns (I14) | Reduced trust in modern medicine (I14) |
| Greater historical exposure to colonial medical campaigns (I14) | Higher likelihood of refusing noninvasive blood tests for anemia or HIV (I12) |
| Greater historical exposure to colonial medical campaigns (I14) | Worse health outcomes (higher rates of anemia and lower vaccination rates) (I14) |
| Greater historical exposure to colonial medical campaigns (I14) | Less successful World Bank health projects (I15) |
| Greater historical exposure to colonial medical campaigns (I14) | Lack of correlation with trust in non-medical institutions (I24) |