REVIEWS

Dr Leader Stirling, Tanzanian Doctor, with an introduction by President Julius Nyerere, C.Hurst and Co., London, 1977.

Leader Stirling’s discursive tale of his forty years in Tanzania is both an important historical document and entertaining reading. In 1935 he went to Tanzania as an expatriate missionary doctor and ended up as a citizen and the Minister of Health. Tanzanian Doctor describes how this metamorphosis took place.

The book is full of striking anecdotes about long journeys through tropical forest and scrub land on foot, wild animals, muddy roads, and the characters of his early missionary days, such as Edith Shelley who did so much towards integrating leprosy into other medical work. Inevitably, there is much about medicine and some of the details may be a bit vivid for the squeamish.

As Mwalimu Julius Nyerere points out in his Introduction (which is in fact a far better review of the book than I can attempt) Leader Stirling and his fellow missionaries in southern Tanzania worked very hard to provide and improve both preventive and curative medical services in the rural areas – a field in which independent Tanzania – has gained a considerable and well earned reputation. Dr Stirling does not attempt to hide his pleasure in ultimately finding himself holding the reins of this work in the Ministry of Health.

I found much of this book compulsive reading and was only sorry to see that it was so expensive – £5.50. Unfortunately, too, the photographs do not come out very well, but perhaps they bear mute witness to the unbelievably simple and primitive conditions in which Leader Stirling and his colleagues laboured for the health of the people in those early days.

Jill Everett

RELIGION AND POLITICS IN TANZANIA

Vision and Service – Papers in Honour of Barbro Johansson – Editors Bengt Sundkler and Per Ake Wahlstrom, September 1977, Uppsala.

The Scandinavian Institute of African Studies and the Swedish Institute of Missionary Research in Uppsala have published this delightfu1 collection of papers to mark the 65th birthday of a very remarkable woman, Swedish by birth, Tanzanian by adoption, who is both a committed Christian and an African Socialist. It contains not only the reminiscences and tributes of old friends and members of the family, some of whom are distinguished scholars and statesmen, but also papers by a wide range of academic writers which together make an original contribution to the recent history of Tanzania and throw a ray of light on the role of the Christian church in a one-party state and in Africa as a whole. We are given glimpses of Barbro Johansson’s warm personality but also of the country and the people she loves so much.

Bengt Sundkler in his recollection of ‘First Steps in Bukoba’, where he became the bishop of the Lutheran Church and where she arrived as a missionary teacher in 1946, remarks that she was following in her father’s footsteps. Anders Johansson had been a primary school teacher and headmaster and later became a city councillor of Malmo in Sweden. His daughter, Barbro was in the same way, first a teacher and later a politician.

Barbro Johansson began work at the Kigarama Teacher Training College (which was then only for boys) and in 1943 re-opened and rebuilt the Girls School at Kashasha, Bukoba. At this time Tanganyika was still a British Trust Territory. President Julius Nyerere, in his foreword to this little volume, recalls how he first met Barbro when she was a head-mistress. Later the party he led invited her to stand for the Legislative Council when – according to the constitution of the time – it was necessary for TANU to support one African, one Asian and one European candidate in each constituency. She was elected then and re-elected in 1960 to the Parliament which was to take Tanganyika through Responsible Self Government to Independence and to Republic status. In 1962 she became a Tanzanian citizen.

Later, on President Nyerere’s request, she became Principal of the Girls Secondary School, Tabora. From 1970 to 1972 she served as a diplomat in the Tanzanian Embassy in Stockholm. The present Ambassador, Mr J.E.F. Mhina, traces the friendly relations between Tanzania and Sweden back to Barbro’s initiative in 1960 when she introduced Julius Nyerere to the political leaders of Sweden at her sister’s house.

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[jumps to review of book about history of medicine in Tanzania ?]

One of the earliest preventive schemes was soon after 1891, when 5 German military surgeons arrived in the country to establish a medical department. The chief medical officer noted that smallpox lymph vaccine from Germany and South Africa had lost much of its potency by the time it arrived in Tanganyika. He arranged for manufacture of vaccine and made it available to the local African prpulat1on. The vaccine was produced in Dar es Salaam until the British took over the administration in 1916.

In 1877 the first hospital and training school for the non-European population was opened in Dar es Salaam. This was through the generous donations of Sewa Haji, a wealthy Indian merchant. The Sewa Haji Hospital continued to function for 67 years and there is now a Sewa Haji Ward Block at Muhimbili Hospital.

In the 1920’s hospital and dispensary services and also environmental health services were developed and the beginning of a maternal and child health service was established. The missions were also making a valuable contribution to services. During the thirties with world recession the health services of Tanganyika suffered accordingly, although there were important developments in the training of medical auxiliaries. The authors devote a chapter to the development of university medical education and there is also a summary of the history of Makerere Medical School.

The second world war put a strain on an already overburdened service but some light was thrown on the health of the adult male population since about 250,000 African recruits were examined by the medical department during the war years. Out of one batch of 4,000 recruits one third were pronounced unfit and only one third were fit for Active duty.

In 1942 the Government appointed a medical officer exclusively for the health of the labour force whose primary duty was to advise employers on promoting the health of their workers and make recommendations to the labour beard.

There was steady improvement in the health service after the war with a new medical director and an expanding budget and staff. The new director was the first to prepare an objective long-term plan for the future development of health services.

The authors consider in some detail the first and second five-year development plans and consider the 1973 review proposals for health development which deal with decentralisation of the service, organisation and plans for training personnel.

This is a fascinating little book on the history and development of Tanzanian health services, full of interest for the lay reader. Health service personnel and in particular those planning and organising services will find this book valuable.

Peter Christie

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