African Medical Care: A Focus on Cultural Aspects

“African Medical Care’s Past, Present, and Future: A Focus on Cultural Aspects”

General Demographics:

• Population: 910.8 million (14% of world’s population)
• 54 Countries
• 27 official languages, around 1800 spoken

(“The Africa Book”, Lonely Planet organization, p. 12, Sept. 2007)

2755-2255 BC: “Egyptians have considerable development in area of medicine”

(“The Africa Book”, Lonely Planet organization, p.8, Sept. 2007)

Ghanaian , Ethiopian (Abyssinian), Songhai empires

http://www.encyclopedia.com/topic/Songhai.aspx#2-1O142:Songhai-full

Why is it so important to understand Africa’s history with colonialism?

Present: Independent but still in need

No cohesive African culture: it’s across the board because of the terrain and history of each country

* cosmopolitan (Alexandria in Egypt, Lagos in Nigeria and Johannesburg in South Africa)

* developing cities (Antsirabe, Madagascar)

* rural villages (Garoua Boulai, Cameroon)

Northern Africa: Mediterranean influences esp. Algeria (has Roman ruins), Egypt has culture of its own

Sahara: strong Arabic and Muslim influence

East Africa:

* British colonizing Kenya,

* North and South Sudan’s war: the impact of refugees influencing countries' overall health needs

West Africa: Connection with France is key

* immigration, education of healthcare professionals like nurses and doctors

* prevalence of AIDS

* malaria

AIDS: problem in Southern Africa, where “the region contains nine of the 10 highest HIV/AIDS infection rates in the world”

(“The Africa Book” Lonely Planet, p. 202).

Small island populations- Mauritius: heavy Indian influence because 2/3 of population are descendants of indentured Indian plantation workers

(“The Africa Book” Lonely Planet, p. 199)

Different aspects of culture

1. Perception and role of men and women- important for access to treatment

2. Traditional doctors

- in medical fields, often stigmatized

3.Community and role of local traditional leaders

5. Importance and diversity of language

i.Example: Dr. Heuric and Mireille Rakotomalala know

English,

French,

Malagasy,

some Fulani ,

some Gbaya,

some Pigeon,

and some Swahili

ii.You cannot attend to a people’s medical needs if you do not take time to invest in their culture and communicate to them in their language

6. Malaria

1.People die of preventable (environment can be controlled by mosquito nets) and curable (treatment is available) diseases

ii.Diseases that children die from such as cholera- sanitation is sometimes an issue

6. Wealth and the consequential access to healthcare

The rich get the treatment, the poor don’t always

7. Politics: ethnic friction, civil wars and refugee medical needs, distract government from administering appropriate healthcare

* government corruption prevents the money from going to the right project

What hasn’t worked: Mercy ships- Monrovia, Liberia

What has worked in the past:

DOTS: Directly-Observed Treatment, Short-Course

"Necessary Treatments” Tina Rosengerg, New York Times, Sept. 19, 2004

Mozambique: Working with traditional doctors

“Engaging Indigenous African healers in the Prevention of AIDS and STDs”, Edward Green, 1999

What is going on now and has worked:

* PAACS: Pan-African Academy of Christian Surgeons

*Baptist hospitals in NW Cameroon: Bingo and Banso

*Institut Pasteur in Madagascar

Future:

*potential investment by Sanford Health

Cameroon:

Cameroon Baptist Convention (CBC):

Banso Baptist Hospital

Bingo Baptist Hospital

ELCA-sponsored hospitals

PAACS: Pan-African Academy of Christian Surgeons

Madagascar:

Institut Pasteur

Lutheran Hospitals:

Antanimalandy

Ghana: Sanford involvement in microclinics

Monrovia, Liberia: port for Mercy ships

Western Influence on Healthcare in Africa