Session 153: Initiative and Response: Vietnamese Actors in the Introduction of European Medical and Technical Systems to Vietnam

Organizer and Chair: Michele Thompson, Southern Connecticut State University
Discussant: Lewis Pyenson, University of Southwestern Louisiana

Recently Asia has played an important part in widening the fields of medical and scientific history beyond the thematic and theoretical factors which located these disciplines firmly in Europe and North America. It can also be said that familiarity with history of science and medicine has provided new avenues of investigation for scholars whose geographic focus lies within Asia. Too often however, there is an intellectual divide between those who study traditional Asian systems of medicine or technology and those who study western technology and medicine in its Asian context. This panel will focus on the Vietnamese players in technical and medical endeavors which combined French and Vietnamese practical and theoretical perspectives. David Biggs looks at Vietnamese and French hydrological works in the Mekong Delta and at the environmental changes wrought by them. Michele Thompson discusses a French doctor's work with the Nguyen royal medical service and their importation of smallpox vaccine to Vietnam. Annick Guénel's work as a biologist informs her examination of Vietnamese theoretical constructs concerning malaria and their contribution to the evolution of malaria control programs. Laurence Monnais-Rosselot will argue that a blending of local practices and Western medicine formatted current Vietnamese national health policy. Lewis Pyenson's knowledge of French colonial scientific programs will inform his comments on our individual papers and on issues raised by members of the audience.

French and Vietnamese Civilizing Missions in the Mekong Delta
David Biggs, University of Washington
From 1858-1930, the French colonial regime in Vietnam directed a series of canal dredging projects that led to over 1300 kilometers of new waterways, transforming the Mekong Delta into an agricultural center of Southeast Asia. Colonial governors referred to these 'public works' as evidence of the 'benevolence' and superiority of French civilization and technology. However, the French were not the first to cultivate and dredge the Mekong Delta. Since the 1750s the Vietnamese royal court had encouraged intensive settlement on their southern frontier with Cambodia. Vietnamese soldiers and laborers built garrisons and dug large canals in the 1800s. The physical transformations brought on by both the Vietnamese and French regimes included efforts to survey the land and to pacify local resistance-in sum these were two civilizing missions. This essay looks at these missions and the environmental changes brought on by them in the late 1800s. Both Vietnamese pioneers and French colonizers sought to build systems of land tenure and infrastructure on the frontier. The end results were the creation of a hybrid culture not entirely French or Vietnamese but one born of futuristic visions and local contingencies.

A Medical Mission: The Vietnamese Quest for Smallpox Vaccine
Michele Thompson, Southern Connecticut State University
1820 was a momentous year for the four men at the Nguyen court who enacted an independent Vietnamese expedition to obtain smallpox vaccine. Gia Long, the reigning emperor at the beginning of the year, died on January 25 and his son Minh Mang inherited the throne. Two of Gia Long's courtiers, Philippe Vannier and Jean Marie Despiau, were involved in Gia Long's initial acquisition of information on vaccination for smallpox. They also served Minh Mang by planning and carrying out an expedition to Macao to bring vaccine back to the court in Hue, thus completing one of the projects left unfinished by Gia Long when he died. Despiau successfully transported live vaccine from Macao to Hue for the immediate objective of vaccinating Minh Mang's children. The expedition also succeeded in transferring smallpox vaccine on a potentially long term basis to the royal medical service. Five months after the mission to Macao, Despiau still had active vaccine on hand in Hue and he had trained ten Vietnamese physicians to vaccinate. For the Nguyen medical service to have kept vaccine going for so long indicates that Despiau and the Vietnamese doctors he worked with understood very clearly how to maintain the live vaccine. The details of the mission, as examined in this paper, will reveal what a notable accomplishment this feat of medical cooperation was.

Malaria Control, Land Occupation, and Scientific Developments in Vietnam
Annick Guénel, CNRS-INSERM, Paris
Long before the French colonial era, malaria was a major factor in the struggle for land occupation in Vietnam. This is illustrated by the land distribution among the different ethnic groups in Vietnam before the colonial era. To this land distribution were linked popular beliefs about the disease etiology of malaria among the dominant group-the Viet or Kinh. In the nineteenth century, Europeans considered all of Indochina as lands propitious for malarial fevers. This view was supported by hospital statistics which ranked malaria as the first cause of morbidity among the Vietnamese. These statistics in turn supported the need for a State-sponsored prophylactic measure-wide-range distribution of quinine. The first epidemiological data emphasized the specific distribution of endemic areas which were more systematically explored during the 1930s. By that time, the Pasteur Institutes had set up a service for "scientific malaria control." Since the end of the Indochina Wars, changes have taken place, not only in regard to the stakes involved, but also with respect to the actors implicated in malaria control in Vietnam. This paper will include a history of malaria control in Vietnam during the twentieth century, and will focus on the particularities of malaria history in Vietnam, the contributions of local knowledge and techniques in the evolution of control measures, and on the structure of relationships among different local communities in Vietnam affected by malaria control measures.

The Development of Health Care in Vietnam: In the Shadow of the Colonial Hospital (1860-1939)
Laurence Monnais-Rosselot, University of Montreal
In 1864 the first non-religious French hospital for Vietnamese people opened in Choquan (Cochinchina). By 1936 nearly a thousand health facilities served the regions of Cochinchina, Tonkin, and Annam. There was a continuity in French public health policy in which institutions such as hospitals and vaccination programs were considered to be the most effective way to fight disease. French colonial urban hospitals and rural clinics and infirmaries supplied people with medicines and launched education programs on hygiene and disease prevention. Colonial doctors were also engaged in medical research. This paper traces the history of western medicine in Vietnam from 1860 to 1939 and shows how medical institutions were shaped by French colonialism. I will argue that this was not simply a basic transfer of Western techniques onto Vietnamese society, but rather that it was a slow blending of Western medicine into local practices. For example, in the 1920s, French administrators and doctors who understood the financial advantages of "traditional medicine" for their patients began to use it in their own clinics along with Western medical practices. These practices were to set the foundations of current post colonial Vietnamese national health policy.

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