This dissertation focuses on the relationship between sovereignty and medicine in Eritrea through an examination of the vernacular medical infrastructure Eritreans devised to deliver victory in Eritrea’s armed struggle for independence against imperial Ethiopia (1961-1991) – the longest war in modern African history. This study examines how contemporary renderings of independence are shaped through lenses of injury, conflict, and medicine particularly concerning the evolution of medicine and infrastructure. At its core, this research seeks to answer the central question: what does framing independence through physical injury tell us about post-independence infrastructure? To address this question, this study harnesses historical data and ethnographic research, conducted in the central and southern regions of Eritrea as well as the United States Eritrean diaspora community. Unveiling the multi-layered understandings of injury, war, and medicine, this dissertation delves into the long history of foreign invasion and illness that generated a medical crisis in Eritrea and eventually spurred Eritreans’ liberation struggle. It archives and probes ad hoc clinical techniques Eritreans developed in the trenches of war, the local paradigm and practices of sustainability that defined the war effort, and how the domestic and diasporic political-medical geography that Eritreans forged during this period of war for liberation continues to inform statecraft in Eritrea. Ultimately, this dissertation yields insights about understandings of medicine and governance in Eritrea as a critique of colonial rule and the implications of Eritrea’s national independence as a political project amid competing geopolitical agendas in the Horn of Africa.