Explanations of modern geographic patterns frequently must be grounded in examinations of the historical developments that established and modified processes at work on antecedent patterns. Many new insights about the operation and spatial arrangement of service-delivery systems have come from studies of the historical evolution of those system. Health-care delivery in modern Africa, for example, continues to be strongly impacted by the pattern of facilities established by Protestant and Catholic religious orders in early periods of European colonization in the 19th and early 20th centuries. This project will use perspectives and techniques of medical and historical geography to assess how the health of African people and the conditions of the places they inhabited were changed by the activities of religious medical missions. It also will examine the ways that native Africans responded to the different medical, social, and technological features associated with the missions. The analysis will focus on two longitudinal, comparative case studies of missions in Kenya and Malawi. Information for use in this analysis will be gathered from government and institutional archives, from informal interviews and field observations in the study areas, and from oral histories of people who were involved with mission facilities over the last 70 years. NSF funding will complement support for this project provided by the National Geographic Society through its Committee for Research and Exploration. This project will provide specific information about the development of religious medical missions in the study areas. The analyses of this information will contribute not only to focused understandings about the historical geography of medical care in these nations; it also will enhance general understandings of the ways that institutional activities originating in foreign cultures interacted with indigenous populations to alter ways of life and standards of living.
