A doctor in Nigeria (1948)

[Music] my name is Faulkner I joined the Nigerian medical service about four years ago partly because I'd always been interested in the problems of colonial medicine and partly well I suppose I was attracted by the idea of a new and active life in a developing country my first introduction to Nigeria was through Lagos the capital it's here that the medical headquarters are situated and here that I met the director of Medical Services before the beginning of my first tour the DMS Dr manua explained the system of decentralization from his headquarters through the Regional Offices to the districts in the districts the ultimate responsibility for the hospital and Rural Health work rests with the district medical officer an assignment of considerable variety and interest Dr Langdon as a single man was going to take over a field unit in the Northern Territories he would be completely mobile and would cover vast distances in the treatment and reduction of epidemics Mass surveys and research work my job was to be in the South as medical officer centered on Calabar in the Creeks District an area of approximately 4,800 square miles next day Dr Langdon set off on his 600 mile track North by train I went by air with my wife and small son who had come out with me calibar is the name both of a town and a medical area the focal point of my work is the General Hospital St Margaret's there are also five smaller ancillary hospitals including units for maternity cases and infectious diseases and seven outpatient dispensaries scattered throughout the area the work of course is far more varied than one would expect to find in a European country in addition to the clinical conditions common to all countries the range of tropical diseases is very extensive one of the great advantages that the Colonial Medical service has over the system at home is that a medical officer can follow his patients right through he acts as physician surgeon and social worker and the patients remain under his own eye until the treatment has become effective besides a very large outpatient Department this hospital has 140 beds with a nursing staff of 36 orderlies and 10 nurses who work under the supervision of a European state registered nurse who acts as matron to assist me at the hospital I have two African doctors one of whom acts as house surgeon there are two operating theaters at St Margaret's both well equipped with instruments for General use there's no anesthetic apparatus so spinal pentathol or open drop methods are used hernas of all kinds form the majority of cases on a theater list the surgical conditions common at home such as appendicitis and so on are rare in this part of Africa the old Tale about West Africa being the white man's grave have long since been exploded we find the climate of Calabar somewhat trying in the wet season but on the whole all three of us keep remarkably fit our house is Airy Pleasant and well equipped and we're supplied with homes by the way and at a fixed rent there is plenty of domestic help and this alone makes housekeeping much easier for my wife than at home and as for my son Jonathan he has different pets but that's about all when he's old enough we shall have to send him back to England for his schooling still that won't be for some time a doctor's life is the same wherever you are and you can't get away from the job for very long it was a call from the sanitary inspector to say that there was a suspected outbreak of cerebros spinal menitis at a village called Big qua this is normally a job for the medical officer of Health but as he was already up country I was asked to call in and pick him up on route I found the medical officer of Health at St Andrew's College carrying out one of his routine checkups he's responsible for public health he has 10 qualified African sanitary inspectors to assist him in this work which is much the same as that of an at home fortunately the center of the reported outbreak was accessible by car and not as frequently happens miles out in the bush as soon as we arrived at Big Qua we met the chief of the village and learned from him the extent of the outbreak the district commissioner had already arrived to give what assistance he could the conditions in Nigeria are still similar to that of Europe a 100 years ago when CommunityWide diseases took their toll of the population a great number of these people have already been rendered anemic by hookworm and malaria their resistance is therefore so low that an outbreak soon reaches epidemic proportions these epidemics usually occur in the dry season about Christmas time the infection being dust born through the district commissioner we commandeered a suitable building for use as an emergency hospital and also made arrangements for the sick to be brought in straight away from the surrounding area at the same time we sent a telegram to Regional headquarters at anugu asking for the help of the nearest mobile field unit these units do a great amount of research work out in the bush and consequently it sometimes takes a day or two for them to get back to their trucks and so to the scene of an outbreak meanwhile back at Big Qua we tackled the epidemic to the best of our ability until the field unit could arrive and take over as no trained assistance could be spared from calibar we had to enlist the aid of the villagers the treatment of cerebros spinal menitis consists fundamentally of giving sulfide drugs working as we were short staffed and practically single-handed we were frankly very grateful when the field unit arrived sooner than we had expected I was delighted to meet up again with Dr Langdon whom I hadn't seen since my departure from Lagos Dr Langdon with the help of his trained staff soon had everything in hand leaving Dr Freeman and myself free to return to our normal duties tropical diseases are generally easy to diagnose due to the specific and easily recognizable nature of the organisms this factor is a great help in the task of reducing the causes of epidemic diseases one of the first aims of Colonial Medical Practice but there is still a vast amount of both field and research work to be done but life is not all work we find plenty of time for recreation in the calibar area there are facilities for all outdoor activities besides tennis we can play golf badminton hockey or Cricket to name but a few nearly everyone plays and we get up the occasional tournament which helps to keep one up to the mark in the evenings we entertain at home or go out to the club where we have a membership of over 150 quite a crowd when we hold a dance in short we lead a social life just before the end of the tour my wife returned to England to fix up our holiday we receive a week's leave for each month of the and I was left on my own to continue one of the many interesting jobs that I have is the regular fortnightly tour around the dispensaries in the outlying districts one of these dispensaries is at the Village of ionu which means a trip up the cross river [Music] oh [Music] it is on occasions like these that one realizes how vast this country is almost as large as the whole of Western Europe with more tribal communities than there are countries but for me the river trip is never long enough and though the country is still Pleasant the dusty Sandy roads are very trying because of the long distances we have to cover a car is even more essential than at home so facilities are given us by the Nigerian government to purchase a new one by installments on arrival for the first tour this dispensary like the other six in the area is under the control of the Native Administration they pay for the drugs and for the salaries of the qualified attendants the dispensaries are for the treatment of minor complaints ulcers wounds scabies and so on I inspect the more serious cases and if necessary I bring them back to the hospital at calbar for further treatment the prejudice against medicine and surgery is disappearing among the Africans and the desire for European treatment has now outstripped Supply an 18months tour under these circumstances passes quickly and the long leaves granted to the Personnel of the Colonial Medical Service are well suited for those who wish to increase that already extended knowledge by postgraduate or refresher courses I have done three tours now and I shall be back for my fourth the [Music]