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This study is a historical examination of the dynamics of the colonial public health system in a British urban city of Enugu-Nigeria. It suffices that until the outbreak of the Second World War, public health programs of the British in the African coal-mining city were prejudiced and influenced by medical racism, class distinction, and political elitism which excluded African urbanites from the basic public health programs of the British in Enugu. Drawing its sources from the annual medical records, Second World War memoirs, and township ordinances of the British in colonial archives at Enugu, the study argues that public health in colonial Africa was not public in application but selective, discriminatory, and racial. The alienation of most Africans from the public health programs calls for a reappraisal of the idea of public health and urban residency in colonial Africa. The study affirms that the democratization and extension of public health programs to Africans, especially those considered “valuable” to the Allied war efforts, were borne out of unintended consequences and should not be considered as part of British benevolence to Africans. The study adopts a quantitative historical research method. The public health services in colonial Enugu are thematic and chronologically arranged in a narrative style. Statistical data are quantified and compared to ascertain the degree of British exclusion and inclusion of Africans in the colonial public health system across time and space. The result of this study shows that public health programs in colonial Africa were not public. It also reveals that most African urbanites in colonial cities were not considered worthy of healthy living nor access to medicals, hence the recreation of eighteenth-century scientific and medical racism in colonial urban spaces.

“How public is public health?”: A historical appraisal of public health services in colonial Enugu-Nigeria, 1917–1960