Alan Lim explores the ethical implications of colonial medicine at the London School of Hygiene and Tropical Medicine to shape a more conscientious and ethical future in medical education and practice.

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There is an intricate relationship between colonialism and the development of medicine. Historically, the study of medicine often overlooked the human aspect, focusing predominantly on biomedicine. However, the growing interest in the history of medicine has increased our understanding of its ties to colonialism.

Recently during my intercalation year at medical school, I pursued my master’s degree at the London School of Hygiene and Tropical Medicine (LSHTM). While in London, I couldn’t help but reflect on how the history of the school intertwined with the British colonial era. The founder of LSHTM was Dr. Patrick Manson, who previously held the role of chief medical officer at the Colonial Office in the government of Great Britain. He also established the medical faculty of the University of Hong Kong, where I am an MBBS student. Dr. Manson, an eminent figure in tropical medicine, played a significant role during a time when Hong Kong was a small far-eastern island on the fringes of the British Empire. Today, both the University of Hong Kong and LSHTM stand as globally renowned institutions in medicine and public health. Yet, how many of us truly understand the connection between their development and the British colonial era?

Photo Credit: Ian Abbott/flickr. Image Description: Front entrance of the London School of Hygiene and Tropical Medicine.

Previous reports in 2022 have surfaced indicating that LSHTM greatly benefited from the exploitation of British colonies. The school was primarily established to train medical professionals for deployment to British-held territories in Africa and Asia, which have tropical climates vastly different from the UK. Similarly, the School of Oriental and African Studies, established in 1916 near the LSHTM campus, was dedicated to training officials and diplomats for overseas colonial service. These schools, along with numerous institutions during that era, were established with the specific purpose of supporting the expansion and administration of the British empire during the period of imperialism.

Unsettlingly, early research at LSHTM often involved using Africans and Asians as experimental subjects. For instance, reports suggest that Manson conducted experiments using his Chinese servant to study the transmission of malaria by mosquitoes. While these experiments may have contributed to advancements in tropical medicine and infectious diseases, they also reflect troubling ideologies, including white supremacy and eugenics.

The power dynamics between colonial authorities and colonised populations create ethical concerns in exploiting colonies for research. The power imbalance raises questions about consent and the responsibility to respect autonomy and dignity in medical research. It is essential to acknowledge that these discoveries, though perhaps advancing medical knowledge in certain areas, were deeply unethical.

LSHTM has acknowledged and is committed to addressing these past transgressions through “decolonization” efforts. In society at large there is increasing recognition of the importance of decolonization. However, these efforts should make us ask whether other medical schools worldwide are doing the same.

Medical education is not just about acquiring clinical skills; it is also about cultivating empathy, and understanding the historical context of the profession. Recognizing the complex history of medicine, especially as medical students, is crucial in shaping us into better and more humane doctors for the future.

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Alan, Lim Yat Chun is an MBBS IV student at the University of Hong Kong