Based on a wide range of historical sources, including published scientific literature and archives (Institut Mérieux, WHO and IMTSSA), this article examines the history of the development of the meningococcal A vaccine between 1969 and 1973. It explores the social factors of vaccine development including various collaborations, informal discussions, the circulation of products and materials, formal meetings, trials and setbacks to highlight the complex reality of the development, production and use of the vaccine. Inscribed in a ‘Golden Age’ of vaccine development and production, this episode not only adds to the scholarship on the history of vaccines, which has tended to focus on a narrative of progress, but also considers the sharing of knowledge through collaborations, and the risks involved in the development of a vaccine. Finally, this perspective reveals the uncertainties and difficulties underlying the production of an effective vaccine.

In the year 1966, the first government hospital, Oshakati hospital, was inaugurated in northern South-West Africa. It was constructed by the apartheid regime of South Africa which was occupying the territory. Prior to this inauguration, Finnish missionaries had, for 65 years, provided healthcare to the indigenous people in a number of healthcare facilities of which Onandjokwe hospital was the most important. This article discusses these two agents’ ideological standpoints. The same year, the war between the South-West African guerrillas and the South African state started, and continued up to 1988. The two hospitals became involved in the war; Oshakati hospital as a part of the South African war machinery, and Onandjokwe hospital as a ‘terrorist hospital’ in the eyes of the South Africans. The missionary Onandjokwe hospital was linked to the Lutheran church in South-West Africa, which became one of the main critics of the apartheid system early in the liberation war. Warfare and healthcare became intertwined with apartheid policies and aggression, materialised by healthcare provision based on strategic rationales rather than the people’s healthcare needs. When the Namibian state took over a ruined healthcare system in 1990, the two hospitals were hubs in a healthcare landscape shaped by missionary ambitions, war and apartheid logic.

In their critical paper on images in the health sciences, Roger Cooter and Claudia Stein pointed out the limits of visualisation and representation in the existing literature in the public representation of health and illness. They focus on the complex and multilayered field of medical representations as the site where levels of epistemic, philosophical and political presuppositions provide insight into the interpreter's historical position. From a close focus on medical (or even public health) representations as a reflection of a partial worldview, to the historical embeddedness that they suggest is the key to understanding the limitations of all visual hermeneutics in the sphere of health and illness: