Urban spaces have been at the heart of spatial control in the colonial global South. The rationalisations used in spatial control include health, security, power display, and modernisation. This Chapter analyses urban planning during ‘the hungry years’ in Dar es Salaam, Tanzania. Employing the rarely used archival materials, it analyses the city’s urban planning decisions and discourses between 1920 and 1939. While the existing literature on colonial urban planning concentrates its analysis on the influential health factor, this chapter argues that health was not the dominant factor throughout 'the hungry years' of the 1920s and 1930s. To illustrate the point, it juxtaposes health with modernity factor using the case of a junior colonial officer, John Pashen, who single-handedly influenced change in Dar es Salaam’s spatial planning emphasis from health to modernisation after 1929. It concludes by stating that the making of urban futures in Dar es Salaam, as in many other cities, was a contested terrain of medical and spatial planners who sought to articulate health or modernity in the planning of cities.