Niklas Thode Jensen: For the Health of the Enslaved: Slaves, Medicine and Power in the Danish West Indies, 1803-1848.

Wright, David

Niklas Thode Jensen

For the Health of the Enslaved: Slaves, Medicine and Power in the Danish West Indies, 1803-1848

Copenhagen: Museum Tusculanum Press, 2012, xi + 352 pp.

Of the many colonial outposts in the 19th-century Caribbean, the Danish West Indies was perhaps one of the most obscure, occupying as it did only a small handful of islands east of Puerto Rico that were ultimately ceded to American hegemony, becoming the US Virgin Islands. In this comprehensive and detailed monograph, Niklas Thode Jensen analyzes the medical history of this colony during the four decades leading up to emancipation (in 1848), illuminating the ways in which "the health of enslaved workers became a central concern for the Danish West Indian plantation owners and colonial administrators" (1). This twilight era of slavery witnessed a steady decline in the population of enslaved workers, as mortality rates were so high that the enslaved population could not reproduce itself. This demographic state of affairs, not unknown in the Caribbean, threatened the future of the sugar plantations. As a consequence, it forced the Danish colonial administrators to respond with public health measures aimed at stabilizing the working population for fear of social and economic implosion.

Jensen focuses on St. Croix (aka Santa Cruz), an island dominated by private and "Royal" sugar plantations. Indeed, it was the Royal plantations--ones that had been taken over by the crown due to insolvency--that yielded some of the richest primary material, ultimately preserved in the national archives in Copenhagen. The author's sources are wide-ranging, including doctors' annual medical reports, the admission registers of plantation hospitals, church records, legislation of various public authorities, and correspondence of diverse authors and visitors to the island. Jensen adopts a largely quantitative approach in mapping out the morbidity and mortality of the enslaved, comparing his results for St. Croix with published literature on the British and French West Indies. The book is divided into two parts, one dedicated to providing a background to disease and healing in the West Indies, as well as the epidemiological, economic, and environmental climate of St. Croix. The second part is devoted to detailed case studies of three domains: nutrition, smallpox vaccination, and midwifery.

A brief review cannot do justice to the diverse findings that Jensen presents, but suffice it to say that life was exceedingly precarious for the enslaved of St. Croix. A combination of rations, dedicated plots of land for the enslaved to cultivate, and occasional "natural" supplementation contributed to a marginal level of existence, one that was characterized by chronic malnutrition and punctuated by disease and injury. Of course, much of the evidence is circumstantial, but the author's comprehensive and balanced analysis makes a strong case that undernourishment resulted in very high rates of childhood mortality. As a consequence, childhood malnutrition was "the major factor behind the demographic decline" (187). On the other hand, the Landfysikus--the royal physician in chief--did engage in what may have been the most effective vaccination protocol in the entire Caribbean, coordinated an impressive system of Danish and native midwives, and oversaw a medical corps that employed contemporary standards of (western) medical interventions, including the introduction of anaesthesia within months of its clinical deployment in the United States. Life was still unforgiving and cruel, but one gets a sense that the prohibition on the importation of new slaves did indeed force the hand of the Danish planters, ushering in a new era where the lives of the enslaved were no longer simply replaceable with new "chattel."

This is an impressive book of nuanced and balanced scholarship. The author succeeds in explaining the economic, occupational, and nutritional aspects of sugar cultivation as well as the environmental factors involved in islanders' health. The illustrations, with eye-catching detail, are magnificent and a compliment to the Press as well as the author. My one criticism would lie in its insufficient transition from doctoral thesis to research monograph. The structure of the book remains too fragmented and repetitive, as the author addresses the possible influence of dozens of factors, disease by disease, each with its own introduction and scientific explanation. One also senses that a major theme--the "continual struggle or negotiation for power over the health of the enslaved [that] took place between the administration, the planters, and the enslaved workers" (4) remains underdeveloped. Such negotiation and struggle seem to lurk in the background, crowded out by the rich, quantitative material. Despite these minor quibbles, this is an excellent piece of scholarship that should become a standard work both in the history of slavery, and the history of health and medicine, in the 19thcentury Caribbean world.

David Wright, McGill University