| Summary: | Because infants are the most vulnerable members of a community, their deaths – and the resulting infant mortality rate (IMR) – are said to signal more fundamental problems that are likely to affect the general health of a community. However, a focus on proximate- and intermediate-level risk factors in epidemiological analyses presents a decontextualized picture and ignores the role of larger forces on health, disease, and illness. In response to this trend, this project will contribute to a revitalization of the use of infant mortality as an index of larger social problems by tempering statistical analyses with critical reflection regarding the effects of the liminal position of Malta within the British imperial system, prior to the Second World War. In addition, by bringing together several analytic approaches which often proceed in parallel, rather than in dialogue – historical epidemiology, social history, and the analysis of colonial discourse – this dissertation highlights the problematics of knowledge production at both the theoretical and methodological level. As a result, my work is not just about Malta, one moment in history, the calculation of infant mortality rates, or the disentanglement of various determinants of infant mortality in this context; it is about the dynamics and repercussions of power differentials and of social, economic, and political inequalities, as they define and structure health outcomes and experiences. Specifically, I will show that fluctuations in international tensions affected Malta’s population on a number of levels because of the island’s importance as a British military and naval base and its location in the middle of the Mediterranean. I will demonstrate how Malta’s “strategic position” restricted political and economic development in the island and articulated with colonial perceptions of the Maltese as “Other” and Malta as “overpopulated.” Finally, I will argue that international tensions, Malta’s location within Empire, and perceptions of the island and its inhabitants in the early twentieth century affected the ways in which infant deaths were explained and understood and the strategies of intervention initiated in the island to curtail infant mortality – all of which had a tremendous impact on the rates at which infants in Malta died.
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