(Photo Credit: Amazon)

History has set African health care up for failure. Lack of trained health workers places a massive burden on many African health care systems, inadequate or non-existent infrastructures make provision of basic needs like food and water impossible, debt and limited budgets move health care to a lower financial priority, medications are expensive and multinational pharmaceuticals want to make big profits, colonialism, apartheid, neo-colonialism, and the effects of an oppressed history perpetuate inadequacies in health care.

The varied record of health in Africa over the past century is inseparable from the history of change in control over political institutions and change in the organization of economic production. In the early years of colonial rule some governments relied on forced labor; in parts of colonial Africa, especially in the eastern and southern parts of the continent, male workers migrated from rural homes, leaving their families behind; in the postcolonial years class differentiation has become more pronounced, with some workers permanently separated from their roots in the countryside.[1]

Feierman and Janzen are right on target again in describing the scene of African health in relation to colonialism, politics, and history. African countries inherited health care systems from colonial authorities, but very often there was no health workforce to fill the void of colonial medical professionals. One Frenchman wrote,

La suele excuse de la colonisation c’est la medecin [the only excuse for colonialism is the doctor] – Hubert Lyantey (1926)[2]

If nothing else colonization was a positive in establishing health care systems and providing professional doctors? I wish I could agree, but mission societies that often ran health services relied on negative images of Africans.[3] The famed Dr. Livingstone was a doctor with the London Missionary Society and is best known for his explorations of the continent that allowed colonial empires to penetrate further into and conquer the African interior.

The slow demise of colonization did not end Western interference in Africa. Well into the 1980s and 1990s some African populations remained under the oppressive control of Western and minority populations. This control led directly to the ill health of those populations, notable South Africa and Mozambique. Black South Africans were denied basic health care services, training, and other needs.[4] South Africa fought a proxy war in Mozambique that specifically targeted the destruction of health care infrastructures. In African countries that gained earlier independence there were other powers to face.

[...] the IMF and World Bank have much to answer for. [Their] policies have eroded Africa’s health care systems and intensified the poverty of Africa’s people. – Salih  Booker[5]

Structural Adjustment Programs (SAPs) and other policies forced by Western institutions made the development from colonialism to independence that much more difficult for African countries. As Hunter writes, these policies often increased the poverty of African populations as opposed to providing for their basic needs. Health became a lower priority as African countries fell into debt because of loans from the IMF and SAPs of the World Bank. Even today with the economic recession African governments are cutting their health budgets to make ends meet. Health services should be the last item cut from a budget as health is central to all other human development.

Health is a major issue in Africa as the basic needs becoming increasingly difficult to provide and there have already been numerous reforms and attempted mechanisms to provide adequate health care.

[2] Hunter, 136.

[3] Ibid, 144.

[4] Hill, 6.

[5] Hunter, 47.

Four modern-day explorers in Expedition Africa (from History Channel)

Reminiscent of the 1800s, a new History Channel show describes a team of explorers, dressed in their colonial khaki, set out to discover the perils of the African continent.

Four modern-day explorers retrace the most famous search in history through 970 miles of hell. They face countless dangers from predators and insects to disease and nature’s own fury. Check out the television event of the summer!

Miles of hell in Africa, oh my! Don’t forget the natural danger!

Between Zanzibar and Ujiji, there are 970 miles of high seas, steep hillsides, scorching plains, fast-moving rivers and mud-filled swamps. Danger lurks around every corner, and any step could be their last.
(Expedition Africa, History Channel)

The webpage for the expedition show describes how the explorers will be following in the footsteps of the great explorers, “heroes” to some of these ‘modern-day’ explorers, Sir Henry Morton Stanley and Dr. David Livingstone.

Stanley a Welsh journalist, who spent a number of years of his life in the US, is best known for finding Dr. Livingstone after he was thought lost in the African bush. Regarded as one of the premier African explorers, a little known fact about Stanley’s African exploration is that he laid the foundation, through his exploration, for the takeover of the Congo (now DRC) by King Leopold II of Belgium. The King was interested in spreading Western civilization and religion to the region as well as claim land. This has led to a still destabilized region where some of the longest running African conflicts are located. Allegedly his expeditions were marked by violence and brutality. He is quoted, “the savage only respects force, power, boldness, and decision.” On a health related note for the central African region, the spread of trypanosomiasis is attributed to the movements of Stanley’s enormous baggage train.

Livingstone’s African exploratory era was marked by the greatest European penetration of the continent. He began his African explorations as a Protestant missionary, but supposedly did not force his preaching on unwilling ears as his main interest was exploring. He was known to travel lightly and was able to negotiate with local chiefs. Livingstone was a man in love with the continent and popularized the search for the source of the Nile. After being ‘found’ by Stanley he refused to return without completing his mission. Just 50 years after his death, colonialism exploded across the continent and was able to penetrate further into the interior due to his work. However, this also allowed missionaries to provide education and health care services to more central Africans. Livingstone was also a staunch abolitionist and made many friends among the African chiefs and populations.

Both men are examples of the Western colonial mindset scarring the African continent. While Livingstone was perhaps a step forward in Western engagement of Africans, Stanley is far from a figure to emulate. The History Channel fails to take note of the important contributions these men made to the destruction of the continent. Instead they focus on the meeting of the two in a popular media tale of discovery in the African wilderness.

Four Westerners with varying experience with the African continent will be followed on their journey that will pit them against the harsh natural environments of Africa. But, this show isn’t about Africa, learning about African peoples, remembering African history or highlighting the difficulties faced in Africa. The show makes generalizations about the continent and perpetuates the myths of Africa as primarily a place of danger. It focuses on Africa as “the unknown, the interior of Tanzania.” If I’m not mistaken people have been living on the African continent longer than any other place on earth. It may be a dangerous, unknown hell full of nature to outsiders, but it is far from a mystery to those who live there. The show seems to be all about these four privileged individuals and the story of their personal journeys. The explorers are worried about mosquitos, disease, death, and surviving. Rightly so in some regards, but what if the story included the people that actually live there?

When will Africa cease to be represented solely by its nature, its dangers and its forgotten history?