Book Review
Colonial Dis-Ease: Us Navy Health Policies and the Chamorros of Guam, 1898-1941
Anne Perez Hattori
ISBN: 978-0824828080 2004 239 pages University of Hawaii Press
Rose McEldowney
Associate Professor in Nursing; Director of the Cultural Safety Research Unit, Graduate School of Nursing and Midwifery, Victoria University of Wellington, New Zealand
Colonial Dis-ease is an important addition to the 'historically underdeveloped' Pacific. It offers an indigenous perspective to the turbulent developments in health that took place on the strategic US territory of Guam between 1898 and 1941. Dr Hattori, herself an indigenous Chamorro of Guam, draws together three major strands - the role of US Navy health workers as participants in colonial power, the reaction of the indigenous people to the US-imposed health policies and the rapid advances taking place in Western medicine at the time. As noted by series editor David Hanlon, Professor Hattori 'rewrites the history of health care on Guam in the context of colonialism'. And it is this context which makes it valuable for nurse and other health care researchers. The period marked the rapid development of scientific and medical research in the Western world with its enormous impact for most cultures.
Guam, itself, has always attracted attention from historians because of its strategic location close to Asia. It was ceded to the US in 1898 after the Spanish-American war and was governed by the US Navy until the Japanese invasion during World War Two.
Dr Hattori's research examines ('disentangles') four health-related policies imposed on the Chamorro people. First, was the forced exile of people inflicted with Hansen's disease (leprosy) to Culion Leper Colony in the Philippines - 'They were treated like animals in a parade'. Second, she highlights the regulations imposed on native healers and midwives and the impact on such issues as maternity, modernity, domesticity, medicine and gender relations.
Third, Hattori focuses on the establishment of the Susana Hospital (for women and children) which became a symbol of tension between two cultures over health care and childbirth ('The cry of the little people').
Finally, Dr Hattori deals with attempts to forcibly eradicate hookworm from Chamorro children even if they presented with no symptoms. Despite a punitive approach, the Navy policy on hookworms failed.
Dr Hattori also provides an excellent overview of health, medicine, politics, science and culture at the time, not only in Guam but also in America and the Western world.
Over the 43 years Navy rule, US power and moral authority over Guam's indigenous people became entrenched. The response by the Chamorros, themselves, varied from resistance to acceptance. Some of the stories Dr Hattori collected reveal that varied response from her people.
Apart from the occasional speculative assumption and misgivings about the end-of-book notes, Colonial Dis-ease is a 'must-read' for nurses and other health workers. It has appeal, too, for readers interested in cultural differences in health care, the power dynamics around health, and recognition of indigenous knowledges. Nurses play an important part in the monograph from the role of the pre-colonial healers (makahna) through the establishment of the US Navy Nurse Corps in 1908 to the establishment of native nurses on Guam. Midwives, too, feature prominently from the work of the native midwife (pattera) through the medicalisation of childbirth with the development of medical obstetrics.
Colonial Dis-ease is graced with excellent maps and photographs and 20 pages of references. It is a welcome addition to the growing knowledge about health, past and present, in the Pacific.
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