Where the doctor is ignorant

05/04/2019 East African Notes and Records: WHERE THE DOCTOR IS IGNORANT More Create Blog Sign In S a t u r d a y, 9 M a r c h 2 0 1 3 WHERE THE DOCTOR IS IGNORANT Martin Walsh by Martin Walsh Flat on my back, beneath the Galaxy, I fear This burning in my groin is gonorrhoea. -- Tony Harrison, Manica When I first went to Tanzania in 1980 my portable medical library comprised the Ross Institute's Preservation of Personal Health in Warm Climates and the Cambridge Expeditions Medical Handbook. The former, aka the Little Red Book, betrayed its origin in a milieu in which the nervous disposition of one's wife and the behaviour of one's servants were common concerns -- more, certainly, than they were to a 22 yearold explorer of the nether regions of Ujamaa (later in life, though, I could have done with an update). The Cambridge Handbook was much more useful, though its diagnostic tables tended to induce hypochondria. Instead A page from the Cambridge Expeditions Medical Handbook of reading possible diagnoses from the combination of symptoms, it was much easier to pick on the worst disease and imagine the symptoms that were listed under it. And so every crick in the neck mirrored meningitis and every instance of colic conjured up appendicitis. Although this is a hazard associated with all self-help health guides, the Handbook's crude diagrams and simple matrices seemed designed to maximise the inflation of illness and a category of anxiety that the Little Red Book didn't cover. The cover of the 1979 edition I first heard about the virtues of Where There Is No Doctor, the English version of David Werner's Donde no hay doctor, from my ethnographic guide Alison Redmayne. I didn't buy a copy until sometime later when I was living in Mombasa. I was persuaded of its efficacy when a sister-in-law living with us in Kibokoni fell ill with shingles, and her head ballooned in an alarming way, and began to resemble a cross between a football and a scaly pufferfish. None of us knew what the cause of this was, and she resorted to a variety of local remedies, including smearing her head with a concoction of herbs. However, after a quick read of Where There Is No Doctor, I was able to confidently declare that she had no need to waste any more money on waganga ("traditional" doctors), because the swelling would go down of its own accord, and the scaliness disappear. As you might expect, no one took any notice of me, but she did indeed get better as I had smugly predicted she would. I've lost count of the number of times I've made use of the book, and for some years I've kept a second copy in Zanzibar so that I don't have to carry it back and forth. One day in Dar es Salaam I found a dog-eared copy of the Swahili translation, Mahali Pasipo Na Daktari, and mama watoto (the missus) has been using it ever since. Never mind where there really is no doctor, the state of medical training in East Africa is such that you need all the help you can get even in places where there is someone with that distinguished title. I'll save the story of my imaginary blood clot -- imagined by some of the finest doctors in Kenya -- notesandrecords.blogspot.com/2013/03/where-doctor-is-ignorant.html Vumawimbi, Pemba, 1995 EAST AFRICAN NOTES AND RECORDS is an irregular blog by Martin Walsh (and guests) and place to post miscellaneous notes about East African history, ethnography, ethnobiology, linguistics, and anything else that comes to mind. It takes its inspiration (if not quite its content and style) from those marvellously eclectic journals of regional and national Africana that political correctness, disciplinary specialisation, and the commercialisation of academic publishing have largely consigned to the dustbin of history. THE ZANZIBAR LEOPARD is a very occasional blog by Helle Goldman and Martin Walsh in which we post news, views and information about the Zanzibar Leopard (Panthera pardus adersi) and sometimes other wildlife in the Zanzibar archipelago. Blog archive ▼ ▼ 2013 (11) ► ► August (4) ► ► April (1) ▼ ▼ March (3) GOODBYE TO ALISON REDMAYNE, MUNG'ANZAGALA SEMUGONG... WHERE THE DOCTOR IS IGNORANT CRASH-LANDING FLYING WIZARDS ► ► February (3) ► ► 2012 (6) ► ► 2011 (12) ► ► 2010 (27) ► ► 2009 (8) 1/10 05/04/2019 East African Notes and Records: WHERE THE DOCTOR IS IGNORANT Some publications for another occasion. I'll also refrain from detailing all the horrors suffered by loved ones, far too many of whom haven't survived to tell the tale themselves. But you get the drift. Over the years Alison Redmayne has performed heroics in ministering to the sick in and around Iringa and Mufindi, and has been an indefatigable campaigner against bad practice in the hospitals and clinics of this particular corner of Tanzania. Talking about this with her one day around the turn of the millennium, I quipped that Where The Doctor Is Ignorant would be a more accurate title for our favourite medical guidebook, at least in the local context. This is not to denigrate the good work that many doctors and medical agencies do in East Africa, or to downplay the difficult conditions in which they strive, often with rudimentary facilities and inadequate medical supplies. But lack of adequate medical knowledge is a serious and widespread problem, and can't be denied. Walsh, Martin 2018. Treasure island: buried gold and the spiritual economy of Pemba. Kenya Past and Present 45: 2332. Walsh, Martin 2018. Esmond in Zanzibar: a personal recollection. In Peta Meyer (ed.) The unassuming American: Esmond Bradley Martin, 1941-2018’, Kenya Past and Present 45: 8. The full text of Where There Is No Doctor can now be downloaded for free from the website of Hesperian Health Guides, together with other community health guides, including Where Women Have No Doctor and Helping Health Workers Learn. These and other resources are also available in a variety of languages, which can be seen at a glance on The Swahili version, c.1984 Hesperian's Resources by Language page. Unfortunately Mahali Pasipo na Daktari, the Swahili version of Where There Is No Doctor, is no longer in print: indeed there are no Swahili resources on the Hesperian site. That's a pity. An updated translation of this and other books, especially if well distributed and accompanied by relevant training, would go at least some way towards filling the medical knowledge gap in Tanzania and other parts of the region where Swahili is widely spoken. References Davies, T. W. Undated [c.1979]. Cambridge Expeditions Medical Handbook. Cambridge: Cambridge Expeditions Medical Scheme. Harrison, Tony 1987. Manica. In Selected Poems (2nd edition). London and Harmondsworth: Penguin Books. 3134. Ross Institute 1978. Preservation of Personal Health in Warm Climates. London: Ross Institute of Tropical Hygiene. [first published in 1951] Werner, David Undated [c.1984, 2nd printing]. Mahali Pasipo Na Daktari... Kitabu cha Mafunzo ya Afya Vijijini. Dar es Salaam: Rotary Club of Dar es Salaam. Posted by Martin Walsh at 19:43 Labels: Alison Redmayne, diagnosis, doctors, health, Iringa, Kenya, Mahali Pasipo Na Daktari, medical training, medicine, Mombasa, Mufindi, Swahili, Tanzania, traditional medicine, translation, Where There Is No Doctor 1 comment: Anonymous 10 March 2013 at 22:43 Nice to see Alison Redmayne's name. She continued to be an indefatigable campaigner until recently. Met her in Nigeria in 1974. P. Harris Reply Enter your comment... Comment as: Publish Walsh, Martin and Helle Goldman 2017. Cryptids and credulity: the Zanzibar leopard and other imaginary beings. In Samantha Hurn (ed.) Anthropology and Cryptozoology: Exploring Encounters with Mysterious Creatures. Abingdon and New York: Routledge. 54-90. Cheke, Anthony S., Miguel Pedrono, Roger Bour, Atholl Anderson, Christine Griffiths, John B. Iverson, Julian P. Hume, Martin Walsh 2016. Giant tortoises spread to western Indian Ocean islands by sea drift in pre-Holocene times, not by later human agency – Response to Wilmé et al. (2016a). Journal of Biogeography, doi: 10.1111/jbi.12882, 1-4. Walsh, Martin 2016. Pygmy tales: tall stories about short people in East Africa. Kenya Past and Present 43: 49-60. Prendergast, Mary E., Hélène Rouby, Paramita Punnwong, Robert Marchant, Alison Crowther, Nikos Kourampas, Ceri Shipton, Martin Walsh, Kurt Lambeck, Nicole L. Boivin 2016. Continental Island Formation and the Archaeology of Defaunation on Zanzibar, Eastern Africa. PLoS ONE 11(2): e0149565. doi:10.1371/journal.pone.0149565. Walsh, Martin 2013. The Segeju complex? Linguistic evidence for the precolonial making of the Mijikenda. In Rebecca Gearhart and Linda Giles (eds.) Contesting Identities: The Mijikenda and Their Neighbors in Kenyan Coastal Society. Trenton, New Jersey: Africa World Press. 2551. Walsh, Martin 2013. Alison Redmayne (1936-2013). Anthropology Today 29 (3): 28. Google Accoun Walsh, Martin 2013. Mung'aro, the Shining: ritual and human sacrifice on the Kenya coast. Kenya Past and Present 40: 1122. Preview Links to this post Create a Link Newer Post Walsh, Martin 2018. The Swahili language and its early history. In Stephanie Wynne-Jones and Adria LaViolette (eds.) The Swahili World. Abingdon and New York: Routledge. 121-130. Home Subscribe to: Post Comments (Atom) Older Post Walsh, Martin 2013. Realizing the potential of collective action groups: coordinating approaches to women’s market engagement. Case study on women’s collective action in the vegetable sector in Tanzania, Oxfam GB, February 2013. Walsh, Martin and Helle Goldman 2012. Chasing notesandrecords.blogspot.com/2013/03/where-doctor-is-ignorant.html 2/10