HEALTH AND MEDICINE — GENERAL 49 1 



also report to the Inspector-General of the Health Services centred 

 at Dakar, who, with his staff of inspectors, is responsible to the 

 Inspectorate at the Ministry for Colonies in Paris, and advises the 

 Governor-General at Dakar. 



In each colony the Chef du Service de Sante has under him a staff 

 of European doctors, of whom the majority are military, having 

 received training in tropical diseases at the &ole d' Application at 

 Marseilles. In addition the trained African auxiliary staff includes 

 'auxiliary' doctors, midwives, and health visitors who have passed 

 through the medical school at Dakar. The medical staff in French 

 West Africa includes i8o European medical officers, 68 European 

 nurses and dispensers, and 30 health visitors; there are 185 African 

 'auxiliary' doctors, 250 health visitors, and 1,733 subordinates. 



In the past there has been difficulty in obtaining French civil 

 doctors, and many foreigners have been engaged as assistants. 

 This difficulty still exists in some degree, especially in Equatorial 

 Africa, so that some military doctors are seconded to the civil 

 branch. All the subordinate staff are trained in the colony where 

 they serve. 



Each colony has its principal hospitals, of which those at Dakar, 

 St. Louis in Senegal, Bamako in the Sudan and Abidjan in the 

 Ivory Coast are regarded as first class. That at Dakar consists of 

 a large building for Europeans, another for Africans with 432 

 beds, which is used principally for surgical cases and does not deal 

 with epidemic diseases [see later), and a maternity building for 

 Africans, which deals with some 800 deliveries per year. The hos- 

 pital at Bamako, on the other hand, appears to be mainly for 

 Europeans and has a large staff in proportion to the patients; it is 

 separate from the dispensary service, which provides mainly for 

 Africans. Hospitals of the second category are at Conakry in 

 Guinea, Porto Novo and Cotonou in Dahomey, and the third- 

 class hospitals, each with a surgeon and radiographer in addition 

 to clinicians, are at Bobodioulasso and Ouagadougou in the nor- 

 thern part of the Ivory Coast, and at Niamey in the Niger Colony. 



These hospitals naturally absorb a part of the staff mentioned 

 above, and the rest is now, or will be, distributed according to a 

 definite scheme as follows: every Cercle or province has one or 

 sometimes two medical centres which correspond to the provincial 



