AbstractThe Northern Territories Protectorate and its people were located on the economic and political margins of Britain's Gold Coast Crown Colony (now Ghana) throughout the colonial period. The article examines how the region's peripherality allowed the Gold Coast Tsetse Control Department to carry out an extensive campaign of bush clearing and resettlement along northern river valleys from the 1930s to 1950s, with little supervision by the Gold Coast Medical Department or northern officials. Intended to control human and animal sleeping sickness and to meet the economic preferences of the colony's central administration, this campaign had the effect of greatly increasing the exposure of northern communities to another disease, onchocerciasis, causing widespread blindness and contributing to a serious public health crisis in the early independence era.