The late provision of medical care to coolies in Indochinese rubber tree plantations: the Michelin model health unit set up in 1925–1939.

International audienceMore than ten years after the British experience in Malaysia, the medical protection of farm workers, in particular the fight against malaria, became in the mid-1920s an economic and social issue in Indochina, in order to protect the future of the huge rubber trees plantations set up shortly before by major industrial and financial groups, where losses due to death, repatriation or escape could amount to over half of the workforce within two years. This situation sparked off numerous publications by the health department of the colony.Several large companies like Michelin, encouraged by the authorities, which had to observe new sanitary measures contained in the 1927 regulation on increased protection for contract coolies, developed their own health programs, similar to that of Malaysian planters. The turning point in Michelin’s plantations was the recruitment of Dr Warnecke, a colonial medicine specialist, and his subsequent assessment of the workers’ health condition in early 1929. From then on, and even if these plantations did not have the highest death rate unlike what is asserted in many works, the management back in the metropole decided to set up a health system with no equivalent in the private sector of Indochina. As a symbol of this effort, a hospital was opened at the end of 1928 in the Dầu Tiếng plantation. It was regarded as a model due to his size and equipment. Michelin also got an early support by the Pasteur Institute, notably following a substantial donation to the latter's malaria-dedicated unit in 1928.The company developed its own methods of quinine inhalation and its medical laboratory, and was at the time the only private company to hire an engineer specialized in antimalarial treatment. A large set of measures to protect workers, women and newborns was taken. Unlike the history of the fight against malaria and of the sanitary supervision in the plantations, which was recently tackled in Michitake Aso’s thesis, that of the health department is still to be written. This paper is based on the Archives Nationales d’Outre-Mer (National Archives of the Overseas Territories), on those of the Pasteur Institute, and above all on several unpublished documents stored in Michelin's own archives, particularly the reports of Doctor Warnecke (89 pages and 69 photographs) and those of Dr Morin from the Pasteur Institute regarding Michelin's Phú Riềng plantation. This communication aims at assessing the efforts made by a company regarded in the metropole as a model in the implementation of a social policy and their limited impact in the special environment of capitalist concessions subjected to productivity requirements, where racial prejudice against the coolies prevailed.Yet, consideration for the human dimension of the workforce came too late to avoid the death of so many workers in the first years (17% of them in Phú Riềng for the year 1928 alone). The behavior of nurses was criticized within the company as they had to fulfill contradictory demands from the management : on one hand dissuading workers from feigning injury or sickness to skip work, on the other hand preventing the worsening of existing wounds which could immobilize coolies for a long period.Dr Warnecke's report demonstrates with figures that this massive investment proved fruitful compared with health care costs in public hospitals, insofar as fewer workers were actually unable to work. It details the entire set of measures taken to improve the coolies’ condition: diet, disease and injury prevention, necessity of getting central medical facilities with competent staff, improvement of the drainage system, etc...Efforts in the sanitary and medical fields admittedly improved the physical and moral condition of workers, but this in the end contributed to an increase in productivity and consequently to a greater exploitation of the workforce, in such a way that the image of the living and working conditions in these plantations has remained negative despite genuine advances