488 SCIENCE IN AFRICA 



It is fair to state, regarding the departmental activities as a 

 whole, that there has been a pronounced concentration in the 

 Gold Coast on the hospital system, and many buildings have been 

 erected in the important towns at great expense. The numbers 

 above show, however, that the system of dispensaries in rural areas 

 has not yet been fully developed. It appears that initiative here is 

 left largely to the African chiefs, and dispensaries are usually 

 erected only by special request. It is true that transport systems in 

 the colony and Ashanti are so well-developed that many patients 

 in rural areas can reach the hospitals for consultation and treat- 

 ment, but provision of this kind can hardly be expected to reach 

 the bulk of the population. 



In 1937 the population was estimated at 3,703,517. In 1936 

 government hospitals had 68 beds for Europeans, 995 for Africans 

 in the general hospitals and 121 in the contagious diseases hospitals. 

 In the same year European in-patients numbered 931 and African 

 26,150; out-patients (European) were 2,095 and (African) 282,035. 



Government medical expenditure in 1936 was ^^3 12,41 3 (re- 

 current) and total expenditure £2,337,357 (recurrent). 



In Sierra Leone the Medical Department, which is under the 

 direction of Mr. P. D. Oakley, has separate medical and health 

 branches. In addition to the European staff of 15 qualified medical 

 officers, etc., there are 7 qualified African doctors, including a 

 senior medical officer and a pathologist. There is a central Euro- 

 pean hospital at Freetown. Of hospitals for Africans, the Con- 

 naught Hospital at Freetown is by far the largest and dealt with 

 2,549 in-patients and 18,193 out-patients in 1936. There are 4 

 other African hospitals at Makeni, Bo, Moyamba, and Port Loko, 

 the last erected during 1936, a fifth was to be erected in 1937. 

 Three mission hospitals in the Protectorate and one in the Colony 

 are subsidized by government, and a dispensary system has 8 

 centres in the Colony and 14 in the Protectorate. Each of these is 

 in charge of a senior dispenser and is inspected frequently by the 

 district medical officers. As in the Gold Coast there has been a 

 concentration of medical work in the capital, and the Colony 

 surrounding it. 



In 1 935-6 the population was estimated at about 2,000,000 Africans 

 and Asiatics, and 700 Europeans. In 1936 government hospitals pro- 



