Surgery and Healing in the Developing World - Dartmouth-Hitchcock

Outreach Dentistry
A B
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Figure 1. An indigenous woman in the Democratic Republic of the Congo (ex-Zaire) had
walked several days to seek help for a dental abscess; but, she was not without here own
resources, passed along in oral tradition. A) She had applied a paste concocted from an
herb “mzawa”, which on later investigation (B) appears to have analgesic properties
previously unknown to this investigator of ethnobotany.
contract are most likely intact, is often a fatuous undertaking. The best way to keep
such a system working at a great remove from its origin is to transport with it the
entire civilization, which had given rise to its invention in the first place. The wellmeaning
gift of high technology equipment is rarely as beneficial to the recipients as
to the donors. And some “high maintenance” donations become White Elephant
gifts if they subtract from the manpower and resources already stressed to keep up
with the more prosaic priorities of the majority of patients’ problems.
An example of one such gift to an impoverished nation was apparent to me
during 1996 when I was the Senior Fulbright Scholar for Southern Africa. I was
working in Hospital Central de Maputo, the largest (and only teaching) hospital in
a nation of 28 million souls. This central large hospital had no penicillin, aspirin or
bed linen following the devastation of 11 years of civil war, but they did have an
MRI scanner, gift of a European nation that had essentially given a “foreign aid
donation” to the employees and owners of the large medical technology firm that
had sent the scanner to Mozambique—where electricity in the nation’s capital was
anything but a reliable commodity. If the funds represented by the extravagant gift
were given in a form that could have been utilized according to the priorities judged
by those closest to the problems, the hospital may have functioned more usefully
than it would have to with a devastated operating budget and one island of First
World technology of dubious utility in the center of the morass inspiring more envy
and anger than hope for the brief duration of its function.
International Medical Education—A Two-Way Exchange
Fortunately, the most portable commodity across borders and languages and
cultural or social systems is information, and the hope that comes from the empowerment
to use the information to the betterment of the people afflicted with problems.
When this knowledge is applied in local systems according to the judgments
of priorities of those managing the afflicted in their own system of health care,
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