engaged each other on and off the battlefield.68
When World War II ended, recently liberated France set out to rebuild at home and reassert its power internationally. Reconstructing the Indochina federation was part of the latter task. But French political and military leaders faced numerous setbacks in 1945 and 1946, most notably tumultuous political transitions in the territories of Indochina, a vicious famine that caused up to two million deaths, and Charles de Gaulle’s resignation as head of the French government, which splintered any hope of consensus on Indochina.
At the outset of the Franco-Vietminh war, which officially started on 19 December 1946, the French military unquestionably outnumbered and outperformed the Vietminh forces. However, by the conflict’s end, culminating in a devastating and humiliating military defeat at Dien Bien Phu in the spring of 1954, the Vietminh had reversed these dynamics. It did so by spending years honing the above-mentioned strategy. Vietminh forces also benefited from mounting opposition to the war in France. Initially, domestic public opinion did not pay much attention to the conflict. The French press did not cover the events, and the majority of those fighting were either private soldiers or colonial troops. By 1953, the new French government, under Joseph Laniel, faced a concerned citizenry that questioned the purpose and cost of the war.69 Dien Bien Phu was the last straw and eliminated any justification for France’s continued presence there. Little did the subsequent French government, under René Coty, know, it would soon encounter a comparable enemy, much closer to home, that had studied the Vietminh and refined its techniques.
International Transformations: Standardizing Health Care and Universalizing Rights
The domestic and regional contexts provided the FLN with the foundation to launch the war in 1954. But it was the international transformations and ensuing doctrines that emerged in the decade after World War II that furnished its leaders with critical tools for their winning strategy. International discourses on health care and welfare, so essential to the Algerian nationalists’ campaign, evolved significantly from the 1850s to the 1950s.
International Sanitary Conferences, the first of which took place in France in 1851 and the last in 1938, were among the first attempts to create health codes governing the human body that would reduce the spread of disease throughout the world.70 The League of Nations Health Organization, founded after World War I, represented a second attempt at formulating global health policy and introduced a common vocabulary about hygiene, which the FLN used during decolonization. Its efforts, along with those of the Epidemic Commission, the Rockefeller Foundation, and the Pasteur Institute, yielded important biological and epidemiological discoveries, but, with the exception of malaria research, their combined work had a minimal effect on the daily lives of those living in the global South.71
During the 1920s and 1930s, language about the right to health and welfare of all people around the world was slowly crystallizing. In some cases, colonial representatives and missionaries brought ideas of health and disease control to rural areas and contributed to what Nancy Hunt calls “a colonial lexicon” that altered the ways in which African women understood reproduction and maternity.72 In other cases, a select number of local medical auxiliaries were trained to assist colonial physicians and to educate native populations about hygiene.73 These intermediaries were critical in connecting biomedical ideas with those of the native populations and helped create a hybrid form of medicine and care.74 But overall, imperial powers did not try to consistently educate the next generation of African physicians, nor did they focus on ways to improve the health of native populations over the long term as they discussed doing for their own populations at the League of Nations. Attempts to address disease-borne illnesses such as malaria and sleeping sickness were the most prominent health-care initiatives throughout colonial Africa. However, these targeted programs did not tackle social root causes and structural inequality that produced disease and ill health.75 In the immediate aftermath of World War I, health care in colonial contexts dealt almost exclusively with disease prevention and was connected with the civilizing mission. It was not yet inextricably linked with humanitarian crises.
French and British administrators were forced to think about health, and specifically colonial health, differently when they encountered a crisis in production in the 1920s and 1930s and had to increase the colonial workforce. Officials admitted that they would need to improve health conditions for laborers if they were going to be subjected to longer hours, dangerous migration patterns, and unsanitary urban dwellings. In Algeria, for example, the Muslim population in urban centers increased dramatically between the 1920s and 1940s. In twenty years it more than doubled from 508,235 to 1,129,482. Population growth in rural areas and in the southern regions of Algeria expanded at a smaller rate (15–25 percent).76 Despite the discrepancy, French administrators had to contend with the reality of sustained and close proximity of Algerians and settlers as well as the demand and pressure for improved health care. For the first time, officials had to address “the shortage and inefficiency of manpower due to debilitating diseases and unsanitary conditions” and quickly find ways to resolve the problem.77
In Algeria, this realization prompted administrators to prioritize the health of the natives, for not only would their well-being effect production but also it stood to boost the metropolitan economy. Certain progressive administrators such as Albert Sarraut believed that Algerian workers would work harder if they were granted some measures of protection, but his was not a widely held position in the 1930s. Not all men in power at the time envisioned benefits from what would have been a significantly different policy approach.
Reluctance to standardize health and labor conditions in the colonies changed after World War II. Empires presented both a challenge and a solution to the crisis of capitalism. On the one hand, the colonies contained an endless supply of laborers who could work toward more production and greater profit. On the other hand, those individuals needed to be healthy to work and required infrastructure to support their transportation and housing needs. Aiming to resolve this particular conundrum, colonial administrators and development experts throughout the French and British empires devised numerous five- and ten-year plans to expand schools and hospitals, build new roads, improve public facilities, and grow industry.78 Although more attention was paid to native health and improving nutrition, colonial officials did not address the social roots of inequality.79
The accelerated pace of development between 1945 and 1955 did not last nor did it generate the sought-after capital to revitalize the French and British metropoles. But the decade-long push created a universal set of terms about health care, development, and modernity that Algerian nationalists were quietly absorbing.80 They observed postwar health-care debates and armed themselves with a fresh understanding of international language. They soon deployed this language to articulate political claims and demonstrate their ability to care for the Algerian population, discussed in depth in Chapters 3 and 4.
Western European and American officials did not anticipate the use by Third World actors of medicine and health care terminology, and that was not the only area from which their language would be appropriated. The rise of international organizations that promoted human rights and a revised commitment to the principles of humanitarianism after World War II fundamentally altered international politics and rewrote the rules of political engagement. Human rights and humanitarianism provided universal ideas that were devoid of race, gender, or religious preferences and therefore were easily transferable to whoever had knowledge of them. These words were disseminated through radio broadcasts and newspaper headlines that the entire world could consume. This was not the first time in the twentieth century that anticolonial actors appropriated Western rhetoric. However, two important features distinguished the 1940s and 1950s: first, the volume of charters and agreements produced, as well as the number of signatories, far exceeded the interwar period, and, second, the level of anticolonial sentiment was at an all-time high.81
The severity and extreme violence of World War II left many Western nations vulnerable and their leaders eager to find solutions that would prevent that scale of war from ever repeating itself. For the second time in twenty-five years, international