This double number of Issue grows out of several long-standing concerns of the Committee on Current Issues and, more immediately, out of panels at the Annual Meeting of the African Studies Association in Baltimore in November 1978. The articles by MM. Moose, Stockwell, Chetile, Raiford, Klare and Prokosch, and Shepherd and by Ms. Seidman were presented in modified form in Baltimore. Mr. Robinson, another panelist, made his Congressional testimony available, while Mr. Nzongola submitted an overview of Western involvement in Southern Africa. We developed the information presented in Baltimore by three members of the Catholic Commission for Justice and Peace into an article, and solicited the contribution from Mr. Bratton as a companion and background piece. Station WGBH of Boston made the transcript of their November 9 broadcast available to us; the transcript became the basis for an article linked to the themes of Klare, Prokosch and Shepherd. The “Directory of Current Research on Southern Africa” is a project coordinated by Mr. Crossey and which we have encouraged as a resource for members of the association. Finally, we wanted to publish Mr. Anise’s analysis of recent events in Nigeria, a subject which has received scant attention in American media.

I shall deal with a limited number of aspects of the traditional healer in Tanzania. A more expanded treatment will be presented in a larger study on health policy and development in Tanzania since 1930. Traditional medicine has been discussed by anthropologists, sociologists, and geographers in ever increasing numbers in this country, probably because research in their fields brought them into close contact with the rural population. Historians and political scientists have been slow in examining the role of the native doctor in the colonial period and since 1961. This does not mean that material on the existence and activities of the African practitioner of medicine was not available. It was the medical doctor who became aware of the existence of African medicine when he found that his treatment was not accepted or was supplemented by visits to the African medicine man.

During the last several years “primary care” has come to the fore as the “new” priority in health care. In September, 1978 the World Health Organization and UNICEF jointly sponsored the first International Conference on Primary Health Care. The following general principles were put forward in 1975 by the 28th World Health Assembly as the basis of successful primary care efforts.

1. 1. Primary health care should be shaped around the life patterns of the population it should serve and should meet the needs of the community.

2. 2. Primary health care should be an integral part of the national health system and other echelons of services should be designed in support of the needs of the peripheral level, especially as this pertains to technical supply, supervisory, and referral support.

We live in an age when baptisms, bar mitzvahs, tahara, weddings, and other significant rites of passage are being observed with decreasing frequency. Indeed, one of those solemn rites–the legal, political, and social transition into adult status at the magic age of 21–has been battered by custom, by law, and even by a constitutional amendment.

I am proud to be here today because I think that, for the first time in many years, the United States has an Africa policy. Some of you may not agree with all of it, but I believe we have your support for our goals.

No regional policy exists in a vacuum. Our Africa policy forms an integral, and important, part of this Administration’s global policy which includes: respect for human rights, a commitment to work for peace and world prosperity; and a striving, increasingly in a multilateral framework, for the resolution of problems in ways which can be of benefit to all.

Few would dispute the claim that traditional medical practitioners provide most of the health care in Africa today. The reasons for this are several and include the availability and accessibility of traditional practitioners to the mass of people and faith in their skills. In recent years much discussion has centered on the issue of integrating traditional practitioners into the modern health care delivery system (Good, 1977). Strong arguments have been mustered on either side of this question, and they are often presented with heated emotion. The degree and level of integration is also hotly disputed, and shades of opinion range from advocating dialogue between the two systems to proposing that traditional practitioners be “legitimized” and integrated into the modern health care delivery system. Most opinions on this broad subject area have been publicly voiced or written by those whose culture reference is western. We know very little about how traditional practitioners feel about the matter.

After the victories of the Front for the Liberation of Mozambique (FRELIMO) and the Popular Movement for the Liberation of Angola (MPLA) against Portuguese colonialism, the liberation struggle in Southern Africa today consists of the heroic efforts being made by the black and brown peoples of South Africa, Namibia, and Zimbabwe to destroy the system of racial oppression established in these countries by white settlers. This system, known in its extreme form of economic explotation and political and cultural oppression as apartheid in South Africa and Namibia, is closely tied to the survival of imperialist interests in Southern Africa. This is why any analysis of the difficulties being faced by the liberation movements of Southern Africa must include a discussion of the specific articulation of imperialism and settler colonialism in this area. For it provides the context in which the African liberation struggle must be understood.

Over the years, studies of materials about Africa, especially in the fields of religion, history, anthropology, culture, and sociology, have contributed to the reconstruction of the predominant modes of thought and reason that led to the rise of the people’s belief systems, values, and religious doctrines. Though limited in many ways and still in the most rudimentary stage, the study of African religion has helped in some ways in the understanding of the basis of thought and action which determine African cognitions and total experience, in other words, African consciousness of his universe, feeling, and understanding of the state of being. It is important that interest in the study of African religion should be sustained, for one is still confronted today–often by those who should know–with derisively cynical questions such as: Is there an African religion? What in fact is it if there is one? Isn’t it really the worship of ancestors? Is not African healing merely the practice of magic and mumbo-jumbo?

My name is Randall Robinson. I am the Executive Director of TransAfrica.

On September 25, 1976, the Congressional Black Caucus convened The Black Leadership Conference on Africa. The conference, comprising the leadership of virtually every national black civil rights and social organization, accomplished two noteworthy objectives. It authored the African-American Manifesto on Southern Africa which expressed grave concerns with the previous Administration’s negotiation initiatives for a Zimbabwe settlement. Secondly, it mandated a task force, chaired by me, to propose and execute an institutional vehicle through which black Americans could express to the Congress and the Administration their views on United States foreign policy vis-a-vis Africa and the Caribbean.

The concept of “brain drain” is in its origins a nationalistic concept, by which is meant a concept that visualizes economic and cultural welfare in terms of the welfare of the residents of a national state or region, viewed as a totality, and excludes from consideration both the welfare of people born in that region who choose to leave it, and the welfare of the outside world in general. Moreover, though the available statistics are far from adequate on this point, there is generally assumed to be a net flow of trained professional people from the former colonial territories to the ex-imperial European nations, and from Europe and elsewhere to North America and particularly the United States. The concept thus lends itself easily to the expression of anti-colonial sentiments on the one hand, and anti-American sentiments on the other. The expression of such sentiments can be dignified by the presentation of brain drain as a serious economic and cultural problem, by relying on nationalistic sentiments and assumptions and ignoring the principles of economics—especially the principle that in every transaction there is both a demand and a supply—or by elevating certain theoretical economic possibilities into presumed hard facts.

The philosophy of African medical practice is rooted in the African world view. Those locating the cause and cure of sickness in traditional practice ask about the ultimate who, rather than what. The answers given are in terms of the cosmological beliefs of the people. I shall deal with the philosophical issues in African medicine with particular reference to causes and cures of sickness in the traditional practice, the human person in this practice, the Christian, the colonial, and modern impact on this view, and a look towards the future. In doing this, I shall show that African traditional medical practice has important contributions to make in technologically oriented medicine.

Following several years of shocking revelations about the United States intelligence service, we now have a unique opportunity to rethink our objectives in the Third World, especially in Africa, and to modify our intelligence activities to complement rather than contradict sound, long term policies. The revelations, and their related publicity, have been a healthy exercise, making the American public aware of what enlightened people throughout the world already knew, that CIA operations had plumbed the depths of assassination, meddlesome covert wars, and the compulsive recruitment of foreign officials to commit treason on our behalf; activities which, if they did not border on international terrorism, certainly impressed their victims as harsh and cruel, whatever their bureaucratic authentication and national security justification in Washington.

This paper addresses itself to the history of pluralistic medical systems in Ghana. Case studies of the systems (traditional and modern-scientific) as evolving traditions with unique premises and techniques will be discussed. Modes of medical institutionalization, recruitment, training, and allocation of resources will be explained. Finally, this paper will attempt to explain the nature of the interrelationship between the two medical orientations in terms of their consequences in health care. The essay will focus on how medical systems are used by consumers and how medical systems are created, maintained, and reformed by professional authorities.

During the period of the slave trade (1650-1830), people were brought from the whole West Coast of Africa to Suriname. The majority had a Fante-Akan (Ghana), Ewe-Fon (Togo and Benin), or a western Bantu (Congo, Zaire and Angola) background, while the Mandingo (Senegal, Sierra Leone and Liberia) formed a minor fraction (Wooding 1972: ch. II). In the course of time they amalgamated into the Afrosurinamese population group, which is subdivided into two main groups: the coastal Creoles and the inland Bushnegroes.

Historically, the intelligentsia—originally the clergy and later men of letters—played a significant role in the development of the Western world. Their importance derived from their function as the critics of society and guardians of its conscience. Institutionally, the intelligentsia were found in the churches and on the margins of society. Later, they moved to schools and colleges that subsequently developed into universities as we know them today. As a class, bureaucrats and technocrats—engineers, doctors, etc.—evolved much later. Their institutional role in society was to implement the ideas of the intelligentsia, particularly those ideas relating to the solidification of the nation-state and the creation of the wealth of the nation. Thus, the bureaucrats and technocrats were much closer to the nation and its historical development than the intelligentsia proper.