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This study analyzes the interrelationship between disease and the politics of British colonial health care in western Kenya in the period 1895 and 1939. Based on a wide array of archival and secondary sources, the study contextualizes the evolution and development of British colonial health care system within the wider context of socio-economic changes in colonial western Kenya. The impact of various diseases on the nature, tempo and direction of socio-economic change in colonial western Kenya is examined. The responses of the British Colonial Office, the colonial state, African, European and Asian communities are also analyzed. The relationship between disease and socio-economic change in colonial western Kenya was complex, dynamic and interactive. Just as disease influenced socio-economic change, so too did such changes impact epidemiological patterns. Changed resource management practices enhanced vulnerability to diseases, the rapidity of their spread, as well as the high rates of infection. Yet colonial health care was neither conceived nor envisioned as a social welfare scheme. Furthermore, it was bestowed a presumed supremacy over African therapeutic practices. Nevertheless, African traditional therapeutic systems maintained their viability and continued to co-exist with western colonial health care. The expansion of colonial health care was gradual, uneven, and underpinned by political as well as economic considerations. Colonial health care was as much a health issue as it was one of political and economic control. Moreover, disease created a dramatic and compelling opportunity for segregationist tendencies, colonial patronage and social control in colonial western Kenya. In the final analysis, therefore, colonial health care was very much a part of the political and economic struggles that characterized colonial Kenya. Its developmental course was shaped by myriad factors: African political, economic and social demands; crises such as epidemics, war and famine; Indian as well as European political and economic struggles for dominance; the colonial state; and the humanitarians as well as the colonial office in Britain.