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Book Review : L'organisation sanitaire en Tunisie sous le protectorat français (1881–1956): un bilan ambigu et contrasté

Medical History
Cambridge University Press
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Benoît Gaumer qualified as a physician at the Faculty of Medicine in Paris and then served for several years as a coopérant (something like a Peace Corps volunteer) in Tunisia. He subsequently earned a doctorate in history from the University of Montreal and is now an associate professor in the University of Montreal's Department of Health Administration, Faculty of Medicine. He is, therefore, pre-eminently qualified to write a history of Tunisia's public health system. He focuses on the seventy-five years of the French protectorate era and manages to cram an amazing amount of information into just 258 pages of text. He begins with an overview of the population of Tunisia, censuses, and health indicators. Subsequent chapters take up the major diseases that struck Tunisia during the protectorate: endemic and epidemic plague, relapsing fever, typhus, cholera, and smallpox, and the early years of epidemiology in Tunisia. The Pasteur Institute of Tunisia plays a leading role in the book. The groundbreaking work of its long-time director, Charles Nicolle, under whose leadership the institute became an internationally known centre for infectious disease research, is featured in a fascinating chapter. Nicolle won the 1928 Nobel Prize for his work on typhus, which he carried out largely in Tunisia. Though the Pasteur Institute was at the very forefront of scientific investigation, the colonial authorities tended to neglect the health, education, and welfare of the indigenous population, and malnutrition and the diseases of poverty were widespread. The major endemic and epidemic diseases, however, nearly disappeared by the end of the protectorate. Gaumier makes it clear that the colonial authorities did not deserve all the credit for this, but were actually continuing a process of public health development begun by the beys of Tunis and their reforming ministers, in the mid-nineteenth century. In subsequent chapters, Gaumier addresses the professionalization of medicine, the development of the Ministry of Hea

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