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The Bight of Benin and beyond; some experiences in the colonial medical service.
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Tropical medicine and hygiene in Tanganyika Territory. Nineteen years in the Colonial Medical Service.
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The enigma of Dr. Benjamin Church; a high-level scandal in the American Colonial Army Medical Service.
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[Pages in the history of military medicine; names of directors and chiefs who have been in the Military Medical Service since colonial times].
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The Ceylon malaria epidemic of 1934-35: a case study in colonial medicine.
In 1934-35 Ceylon suffered a major malaria epidemic which affected one and a half million people out of a population of five and a half million. This paper will first examine the orgins and course of the epidemic but the main focus is on the measures the authorities adopted to deal with the disaster. In 1931 Ceylon had attained 'home rule' under the Donoughmore Constitution. The epidemic was a first and major test of the efficacy of the new government. Examining the responses of the imperial government, the colonial government and the colonial medical services to this medical emergency establishes that the epidemic was a turning point in the health services of Ceylon and thus Sri Lanka, that the legacy of colonial medicine is essentially mixed and that the complexity and contradictory nature of colonial medicine can only be understood by detailed contextual research.
Seeing the wood for the trees--the early papers of Denis Burkitt.
Denis Burkitt's was a remarkable career. A surgeon in the Colonial Medical Service in Uganda, his keen observation of the incidence of jaw tumours in children led him to describe a new form of lymphatic cancer. He confirmed, for the first time in man, that a cancer was caused by a virus and, most remarkable of all, he discovered a cure--low-dose chemotherapy. The condition was named after him--Burkitt's lymphoma--and with this came membership of a select group of eponymous Irishmen, including Graves, Colles and Corrigan. His ability to link the incidence of disease with geographical distribution brought him, first to question and then to champion Peter Cleave's theory that lack of dietary fibre contributed to many of the diseases common in western civilisation. In the process, he changed the dietary habits of the Western world. Yet Denis Burkitt's early career in Trinity College, Dublin was not auspicious for, as a Junior Freshman engineer in 1929, his tutor despaired of him, writing to his father 'Don't blame me if he gets stuck'. A happy irony then, that the College made him an Honorary Fellow half a century later.
Oddi: the paradox of the man and the sphincter.
Ruggero Oddi was born of a modest family in the small town of Perugia, Italy, in 1866. While still a young medical student, he identified the sphincter and in addition characterized its physiological properties. At the early age of 29 years, he was appointed as the director of the Physiological Institute at Genoa, but a dalliance with drugs and fiscal improprieties resulted in his being relieved of this eminent position in Italian Physiology. He subsequently sought employment as a physician in the Belgian colonial medical service and briefly spent time in the Congo. The deterioration of his physical status and his use of Vitaline, a homeopathic preparation, led to the demise of his medical career. For reasons that are unclear, he then traveled to Africa where he died in Tunisia. In the last 50 years, the use of sophisticated methodology has allowed delineation of aspects of the neural and hormonal regulatory mechanisms of the sphincter. Its exact role in disease has not been determined, although its relationship to the putative entity of biliary dyskinesia has been suggested. The paradox of both the sphincter and its original discoverer remain to be resolved.
[Selective health systems: a trap for health politics in the Third World].
The authors examine the evolution of the PHC approach in historical perspective, present definitions and criteria of what PHC actually means, look upon deviations of conceptual content and practice of PHC and end up with a socio-political as well as a technical critique of the so-called 'selective' PHC. Modern health systems evolved in developing countries modelled on the 'western' biomedical health care systems. Yet even colonial medical services contained also progressive elements, as e.g. the acceptance of the need to de-centralise hospital care to peripheral health posts, or the stress on more rational distribution and utilisation of drugs. The vertical programmes developed under this approach showed clearly their limitations and the conference of Alma-Ata can be looked at as a turning point, where a new model of health care, i.e. PHC, was designed. Though there exists a widespread resistance in industrialised countries against adopting this new model, it was not at all limited only to developing countries. As with every innovative idea, the PHC strategy provoked contradictory views and large differences in interpretation. But, the authors stress, PHC is neither a doctrine, or a theory but the outcome of decades of field-experience of concerned scientists and practitioners. The essential criteria of PHC include: Accessibility: need for improved first contact with the health care system, demanding efforts of decentralising the existing health system without neglecting the quality of care on higher-level medical services. PHC is essentially an action-programme designed around the well-known eight PHC elements, designed to meet effective demand and to rationalise medical offer. The eight elements rather underline the multiplicity of health action required--they are not considered to serve as 'chapters' of PHC policy. PHC is a strategy for re-organising health services. The hospitals should serve the peripheral health centres and not the other way round. At the same time, curative preventive and promotive actions have to be integrated. This necessitates community participation, as the global health problems cannot be solved by the health services alone. PHC in so far re-defines the role of medicine and looks at health in a holistic way. Medicine is being de-mystified and individuals and communities are encouraged to take over responsibility for their own health. This is not at all the consequence of an idealistic view, but derived from field experiences in various circumstances. PHC as a new philosophy of health services delivery therefore, stresses: holistic action for global health issues, equity, participation, and cost/efficiency.(ABSTRACT TRUNCATED AT 400 WORDS)
Walter Laing Macdonald Perry KT OBE, Barron Perry of Walton, 21 June 1921 - 17 July 2003.
Lord Perry of Walton died suddenly on 17 July 2003, at the age of 82 years. Walter Laing Macdonald Perry was a native of Dundee, educated at Morgan Academy Dundee, Ayr Academy, Dundee High School and St Andrews University (MB ChB, MD and DSc), winning the Rutherford Silver Medal for his MD thesis and the Sykes Gold Medal for his DSc thesis. After Casaulty Officer and House Surgeon posts in 1943-44, he served as a Medical Officer in the Colonial Medical Service in Nigeria in 1944-46, then briefly as a Medical Officer in the RAF, 1946-47, before embarking on a scientific career on the staff of the Medical Research COuncil at the National Institute for Medical Research from 1947 to 1958, serving as Director of the Department of Biological Standards from 1952 to 1958. Professionally, he achieved MRCP (ED) in 1963 and was elected FRCPE in 1967, FRCP in 1978, FRSE in 1960 and FRS in 1985. In 1958 he came to Edinburgh as Professor of Pharmacology, holding the Chair from 1958 to 1968. During this time he also served as Dean of the Faculty of Medicine (1965-67) and Vice-Principal of the University (1967-68) before leaving to become the inaugural Vice-Chancellor of the Open University in 1968, a post he held until 1980. During this period at the Open University he developed a second distinguish career as a university administrator and a promotor and facilitator of open and distance learning, in which fields he later performed extensive work on behalf of the United Nations. A third career, in politics and public life, began with his ennoblement to a life peerage in 1979, taking the title of Walton in the County of Buckinghamshire, the initial base of the Open University. Latterly Walter sat as a Liberal Democrat, having twice been Social Democratic Party deputy leader in the Lords in the 1980s. He took an active role in the Lords' Select Committee on Science and Technology and held interests in and spoke on many areas of public policy, including fisheries policy. Recognition of his distinguished careers came with a succession of honours; OBE in 1957, Knight Bachelor in 1974 and Baron in 1979; 10 honorary degrees from UK, North American, College London; the Wellcome Gold Medal in 1993 and Inaugural Royal Medal of the Royal Society of Edinburgh in 2000. He was Chairman, President or member of numerous commercial, educational, public interest and scientific bodies. Lord Perry's publications included sole or part authorship of approximately 90 books, research papers and abstracts. Shining through of Walter Perry's careers are strengths of commitment and sheer hard work, rigorous analysis of scientific, educational and organizational problems, experimentation and pursuit of clear objectives. Against scepticism, elitism and ill-informed criticism he drove through the establishment of the Open University. It is today respected internationally, is by some orders of magnitude our largest university in terms of student enrollment and is demonstrably successful outcome from an experiment initiated 40 years ago. It represents a fine monument to Walter Perry.
Dr Harvey Pirie and the Scottish National Antarctic Expedition (1902-4). Scottish science and medicine in the Falklands and Antarctica.
Shortly after receiving a science and medical degree at Edinburgh, Dr Harvey Pirie joined the Scottish National Antarctic Expedition (1902-4) under Bruce. The naturalist team explored East Falkland, Laurie Island in the South Orkneys, and made the first oceanographic investigation of the Weddell Sea. After sighting Antarctica and naming the coast seen Coats Land, they returned to the Clyde via Gough Island and Cape Town. After a period in Scottish private practice, Pirie became a bacteriologist; he joined the Colonial Medical Service in 1913 and served in Kenya. In 1918 he organised the bacteriological services at the South African Institute for Medical Research in Johannesburg, and became deputy-director, 1926-41.
Kenneth Harrison Uttley (1901-1972). Historian to the diseases of Antigua, British West Indies.
Dr Kenneth Harrison Uttley (1901-1972) served as the Chief Medical Officer in Antigua, British West Indies, from 1955 until 1966. During this time, Dr. Uttley personally reviewed and tabulated an island-wide governmental demographic database of all births, deaths and causes of death during the preceding 100 years. This database was the result of a Compulsory Birth and Death Registration Ordinance enacted as one of several Colonial Poor Laws in 1856. His efforts resulted in the publication of a total of 30 papers in American and British medical journals. Many of these papers reviewed historical demographic trends in births, fertility rates, neonatal deaths, infant mortality and early childhood mortality rates. Others focussed on the historical epidemiology of specific diseases such as neonatal tetanus, leprosy, tuberculosis and malaria. This is the first complete bibliographical account of Uttley's contributions to the history of diseases in the West Indies in general and Antigua in particular. Dr Uttley also served as an ordained priest in the Anglican Church and, upon retirement from the Colonial Medical Services, returned to England to serve as the Vicar of Purton, Oxfordshire.
[Industrial medical services in French colonies].
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LIFE in the colonial service by a colonial medical officer.
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Power and privileges in medical care: an analysis of medical services in post-colonial Nigeria.
Subsequent Nigerian Governments since independence have been committed to a policy of health-for-all. The right to medical care is now constitutionally guaranteed. But it takes more than the constitution to translate medical, and indeed all rights, to reality. In practice, as this study reveals, status, power and privileges determine whether or not one gets Western medical services and of what type in contemporary Nigeria. Further, medical services for the generality of the people have remained a second rate priority of post-colonial governments, very much like the situation in colonial days. The care for state employees and other elites continues to take precedence.
Health services and the legitimation of the colonial state: British Malaya 1786-1941.
This article is concerned with the establishment and extension of health care and medical services in British colonial Malaya. Initially, medical care was provided for the colonial elite and those in their direct employment. With the expansion of colonial control beyond trade centers into the hinterland and with the growth of agriculture and mining. Western medicine was extended both to labor involved in these export industries and to others whose ill health might jeopardize the welfare of the colonists. Public health programs in the twentieth century continued to focus on medical problems that had direct impact on the colonial economy, but programs were extended to ensure the reproduction as well as the maintenance of the labor force. This article develops the notion of a legitimation vacuum, and the role of the state provision of social services, including medical services, in legitimizing colonial presence and control.
"Practising hygiene and fighting the natives' diseases". Public and child health in German East Africa and Tanganyika territory, 1900-1960.
For reasons of population policy and missionary strategies, childcare was a relatively early issue of colonial medical policy and services in East Africa. The main challenge for the adaptation of biomedicine to the local situation proved to be not so much schemes for treatment or prevention, but rather the question of staffing. Education and employment of females, as well as social acceptance and keeping up professional standards of biomedically trained personnel, posed major obstacles to the implementation of governmental health policies. In addition to these obstacles, European prejudices about African disinterest in child health contributed to the feeling that limited progress had been made after 50 years of biomedical efforts to improve African child health.