The construction and crystallization of Kenya from a polyglot collection of communities to a colonial terrain, though gradual and uneven, was brought about by a combination of force, diplomacy, and epidemics. A number of communities in Kenya caught the first glimpse of a colonial state through the prism of wars of pacification and taxation, as well as governmental inoculation and vaccination campaigns against epidemic outbreaks of bubonic plague and sleeping sickness. The campaigns against the epidemics, which were the first major tests of the colonial state's choice of methods and monopoly of ideas, proved ineffective. At the beginning of the twentieth century, the suddenness of most epidemics, the rapidity of their spread, and the high mortality rates often astounded both local populations and colonial officials. While the geographical extent of the epidemics was quite often ascertained without much debate, containing the pestilence often called forth several competing strategies and various interpretations.

The state's efforts to contain epidemics produced intense debates among local populations on ways of preventing deaths as well as on the intentions and limitations of the state's methods. In the debates, communities naturally drew from their own past experience. A major issue that has been addressed in this book is the existence of a concept of health and healing in precolonial societies in which indigenous populations envisioned a balanced ecosystem not only as part of their economic and cultural reproduction but also as part of their health and healing tradition. The maintenance of that balance was not achieved merely by the human population's response to the whims of nature, but also by the population's gradual and constant transformation of the environment. As part of that transformation, traditional controls, which often limited the adverse effects of epidemics, evolved. Thus, the challenges presented by epidemics provided situations in which the skills and experiences of indigenous populations were evoked, enriched, and applied with varying success.

Yet with the introduction of the new biomedical and political order, these traditional skills were hardly valued by the colonial state. The irony, however, is that the implantation of British colonialism coincided with the onset of some of the most devastating epidemics ever witnessed in Kenya. Epidemics of sleeping sickness, smallpox, and bubonic plague fell upon Kenya before any colonial medical infrastructure was instituted.