Mistrust in Medicine: The Legacy of Colonial Medical Campaigns in Central Africa*

We examine how historical experiences with modern medicine affect present day engagement with the health sector by examining the legacy of French colonial medical campaigns. Between 1921 and 1958, the French military organized medical campaigns to treat and prevent sleeping sickness. The military forced villagers to participate and used medications with harsh, sometimes fatal, side effects. We digitized over thirty years of French colonial records that document the locations of campaign visits and the intensity of treatment at a granular geographic level for five African countries. We examine how exposure to the historical campaigns affects trust in medicine – measured by willingness to take a blood test for anemia or HIV. Using an IV strategy, we show a significant and positive effect of historical exposure to campaigns on refusal to consent to a blood test. We provide evidence that the mistrust generated by this experience is specific to the medical sector, rather than to institutions more generally. Finally, we examine the importance of these historical campaigns for present day health policy by demonstrating differential response to a universal measles campaign.