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58
The colonial powers trained many physicians, pharmacists,
midwives, nurses, and healthcare workers.They built a num-
ber of medical centers – hospitals, dispensaries -- in their
colonies and protectorates. They developed research labo-
ratories in both Europe and Africa, most notably to fight
against small pox, leprosy, yellow fever, trypanosomiasis,
malaria, and onchocerciasis, etc. But they neglected to study
African beliefs, save to summarily skim over them, insuffi-
ciently appreciating certain behaviours rooted in long-stand-
ing mentalities. They failed to comprehend social realities.
For example, they insisted more on practical training, and
less on theoretical medical knowledge [1, 8].
Despite change after World War I, the vision of superior-
ity did not favour the relationship between the sick and the
colonial physicians. Moreover, indigenous physicians were
less esteemed than European medical doctors. The march
toward independence contributed to a deeper implantation
of colonial medicine. Indigenous physicians were incapa-
ble of continuing the practice of the new medicine because
scientific training requires the transition from ignorance,
prejudice and culturally-specific beliefs to the objective
knowledge derived from experimental science. But the lack
of understanding of African perceptions of illness, death, hy-
giene and health did not allow one to penetrate indigenous
lifestyles and the spread of
disease.Asin Europe, it was only
the point of view of the colonizer -- or rather that of physi-
cians and administrators -- which was considered.Whereas
one recognizes that a health program reaches its goal if it
succeeds in modifying the behaviours of people toward bet-
ter health, so with the participation of populations health
policy succeeds.
Conclusion
Even when colonial medicine abandoned ideology, and be-
came scientific, it was not possible to study African attitudes
towards medicine. It is important to examine attitudes in or-
der to comprehend the rapid change in Africa today, notably
to better manage health programs. Unfortunately, physicians
often refuse to collaborate with historians. The latter are
able to analyze the evolution of attitudes over the long term.
An analysis of African conceptions of hygiene could help to
avoid at least 50 per cent of ailments, because one would be
able to discover how people understand hygiene-related ill-
ness. Perhaps we have to compare the actions of genies and
bad spirits to those of microbes, and to compare prevention
to that which we call “
blindage magique
” --a magical screen
that serves as a barrier to illnesses. In any case, the future
of African medicine depends upon a fuller understanding of
African attitudes to medical practice.
*I wish to thank Gregory Shaya and Penny Paterson for im-
proving the readability of my english.
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Doenças, agentes patogénicos, atores, instituições e visões da medicina tropical