The Colonial Medical System(s) and the Health of Africans

Abstract

We might agree that the health care systems prevalent in Africa today are a relic of the colonial past, primarily initiated during the nineteenth century. Following attainment of independence during the 1960s and 1970s, the new African sovereign states attempted to reverse the course of their histories by announcing that health and education would be free for all citizens—in line with their leaders’ common admiration for the socialist ideology and rhetoric of the Non-Aligned Movement states and the Soviet Union. The latter had provided much assistance to the bold liberation movements and the new independent states in Africa. However, many factors have harmed Africa’s fledgling health care systems: scarcity of resources, geographic location, lack of exposure to commercial activities with the outside world, especially for landlocked countries, improper allocation of funds, and corruption; also, simply the bad choices made in the face of competing priorities. As such, its leaders must be held responsible for the unacceptable health disparities that prevail on the continent today. The colonial legacy might explain partly the differences found in countries’ health care performance and this chapter argues that the colonial health model has left an indelible mark on the existing health care system(s) in Africa. To the informed observer, there is a noticeable difference between countries that were under colonial indirect rule, or faced assimilation, or a more paternalistic form of governance. However, whatever the nuances of their approach, all colonizing states were intent primarily on extracting from Africa what would be beneficial particularly to their citizens, economies and status. It made sense for Europe, a continent divided by long-standing political, religious, and economic rivalries, to use Africa to leverage the humiliations suffered following the concretization and stabilization of the concept of nation-state in Europe during the seventeenth century.