DOI Page / Citation link:
https://doi.org/10.11588/diglit.70004#0147
145
is in theory the country’s main transfer hospital, but which at the same time
is the only hospital for the 750,000 people of the capital, only about 2 - 3% of
its patients are transferred there from the provinces (O’KEEFE 1976, 135).
Doctors are not, however, necessarily a good index of health care provision
for in developing countries it is often nurses and medical assistants who staff
health centres, and even provide services in hospitals where a doctor should
be practising but the position cannot be filled by a qualified person. Thus
the total number of trained medical staff is probably a more suitable indicator
of health care provision. The urban provinces of Lusaka and Copperbelt are
again best provided for, but the North-Western Province is not far behind.
The dissimilarity index for medical staff as a whole is 25.3, which suggests a
moderate inequity in provision.
Other than the state, the churches are today the most important contribu-
tors towards medical care provision. Joined together as the Churches Medical
Association of Zambia, they provide about 30% of available medical services.
The facilities that they provide are all in the rural areas (where two-thirds of
the population live)2, where they supply about half the available health ser-
vices (Table 14). A similar situation applies to Kenya (DlESFELD & HECKLAU
1978, 31 - 39).
However, it can also be seen from Table 14 that there is considerable varia-
tion between provinces in the amount of medical aid provided by the churches.
Whilst they provide between 35 and 60% of the beds in North-Western, East-
ern, Western, Luapula and Southern Provinces, the share amounts to only 23%
in the Northern Province. To explain these spatial disparities it is necessary
to look at the history of western medicine in Zambia.
2. Health Care in the Colonial Era
The first European doctors who came to the area today known as Zambia were
missionaries. David Livingstone had qualified in medicine at the University of
Glasgow before he went to Africa and the first two missions to be permanently
established in the area, the Paris and London missions, both had doctors
amongst their missionaries. This was the case of the other early Protestant
missions, too.
An especially important personality was Dr Walter Fisher, a surgeon from the
Christian Missions to Many Lands3. After working for several years with the
Brethren Mission in Angola he arrived, in 1906, in the Mwinilunga District in
the northwest of Northern Rhodesia. He succeeded in gaining the trust of the
local population and within a few years, despite the trying conditions of this
remote area, he was able to introduce western medicine.
is in theory the country’s main transfer hospital, but which at the same time
is the only hospital for the 750,000 people of the capital, only about 2 - 3% of
its patients are transferred there from the provinces (O’KEEFE 1976, 135).
Doctors are not, however, necessarily a good index of health care provision
for in developing countries it is often nurses and medical assistants who staff
health centres, and even provide services in hospitals where a doctor should
be practising but the position cannot be filled by a qualified person. Thus
the total number of trained medical staff is probably a more suitable indicator
of health care provision. The urban provinces of Lusaka and Copperbelt are
again best provided for, but the North-Western Province is not far behind.
The dissimilarity index for medical staff as a whole is 25.3, which suggests a
moderate inequity in provision.
Other than the state, the churches are today the most important contribu-
tors towards medical care provision. Joined together as the Churches Medical
Association of Zambia, they provide about 30% of available medical services.
The facilities that they provide are all in the rural areas (where two-thirds of
the population live)2, where they supply about half the available health ser-
vices (Table 14). A similar situation applies to Kenya (DlESFELD & HECKLAU
1978, 31 - 39).
However, it can also be seen from Table 14 that there is considerable varia-
tion between provinces in the amount of medical aid provided by the churches.
Whilst they provide between 35 and 60% of the beds in North-Western, East-
ern, Western, Luapula and Southern Provinces, the share amounts to only 23%
in the Northern Province. To explain these spatial disparities it is necessary
to look at the history of western medicine in Zambia.
2. Health Care in the Colonial Era
The first European doctors who came to the area today known as Zambia were
missionaries. David Livingstone had qualified in medicine at the University of
Glasgow before he went to Africa and the first two missions to be permanently
established in the area, the Paris and London missions, both had doctors
amongst their missionaries. This was the case of the other early Protestant
missions, too.
An especially important personality was Dr Walter Fisher, a surgeon from the
Christian Missions to Many Lands3. After working for several years with the
Brethren Mission in Angola he arrived, in 1906, in the Mwinilunga District in
the northwest of Northern Rhodesia. He succeeded in gaining the trust of the
local population and within a few years, despite the trying conditions of this
remote area, he was able to introduce western medicine.