For example, the health care system we built in the 1980s was the envy of the world because it did improve the health of many people. The number of hospitals or the equipment they have are not as important as whether chronic life-threatening diseases are brought under control and the number of undernourished children and of women who die in childbirth is reduced. The efficiency of health services is measured by how they help the most vulnerable.
During the ‘80s we did dramatically reduce the number of babies and mothers who died and we greatly reduced the number of people who died of diarrheal diseases.
We tend to forget that the more “developed” countries overcame the most threatening diseases, like cholera and typhoid, before most modern curative drugs and techniques had been developed. All that was needed was a reliable clean water supply and an efficient sewerage system. Good sanitation prevented infection, which is much cheaper and simpler than paying for treatment and drugs after an epidemic has broken out.
Many of the ills that affect young children and pregnant or nursing mothers can be prevented or minimised if mothers and babies are regularly tested. The earlier a problem is found, the easier it is to solve it.
“Primary health care” became the slogan of the time. Village health workers were trained. Many were traditional midwives, who didn’t need to learn much about immediate care for mother and child. As one of the few people with a car in a rural area where I worked, I learned to respect the judgement of our local village health worker when people asked me to take a sick person to hospital.
If this wise elderly lady said a case was not urgent, that settled the matter. If she said it was, I would waste no time. She once delivered a baby on the back seat of my car as I drove as fast as I could go smoothly; another time we both had to learn quickly how to tell from the bite marks whether someone had been bitten by a poisonous or non-poisonous snake.
(I had a reference book that told us it wasn’t, but if I hadn’t found the answer in less than five minutes, I’d have needed to take the patient just in case they’d been poisoned.) That didn’t only save me trouble. It saved the staff of the local hospital the extra work and stress that an emergency brings and other, more seriously ill patients got quicker and better treatment as a result.
A few simple devices saved many lives. The record card of a baby’s weight told every mother and every responsible father whether a child needed better food, that they could often provide, or hospital treatment. The Blair toilet, developed by a few dedicated researchers in our own Ministry of Health laboratories, had nothing to do with our Old Man’s favourite enemy. It was our own, though we might thank the divine guidance that produced it just when we were ready for it.
It greatly reduced fly-borne diseases and did the job, using skills that local builders could easily learn, so effectively and cheaply that governments and health workers from all over Africa and beyond wanted to learn how to do the same for their people.
So independence was not a complete disaster. If it had not come just when those researchers were field-testing their prototypes, so that a government that most of us trusted at that stage could promote it, it might have remained an interesting oddity for “appropriate technology” enthusiasts.
It did come at the right time, so it saved millions of lives and earned us credit. We could lift our heads high and know we had something the whole world valued.Post published in: Opinions & Analysis