492 SCIENCE IN AFRICA 



hospitals of a British colony, each with a European doctor in 

 charge and some with an African auxiliary doctor as well. Here 

 urgent surgical cases are dealt with, but the chief object of these 

 medical centres is to supervise a ring of subsidiary centres [injir- 

 meries) in charge of native auxiliary doctors, each of which, in turn, 

 is surrounded by dispensaries in charge of injirmiers or nurses. 

 There are usually two or three medical posts with auxiliary doc- 

 tors in each cercle, but in some parts of Guinea and the Ivory Coast 

 there are up to nine in a cercle. In theory the doctor in charge of 

 the cercle visits each of his out-stations once a week. This system 

 is nearly complete for Dahomey and the lower regions of Senegal, 

 and is being extended as native auxiliary doctors and other staff 

 are being produced at Dakar, but there are large areas still with- 

 out dispensaries. The French insist on keeping all African staff 

 under close supervision, and hence do not open more dispensaries 

 than can be visited by European staff at frequent intervals. This 

 attitude may be contrasted with that in the British colonies for 

 example, where, though the African staff is usually less highly 

 trained, its members are often entrusted with more responsibility. 

 Another important difference between the French organization 

 and some British systems is that the hospitals are regarded essen- 

 tially as the headquarters for a large number of field stations in 

 rural areas, rather than as centres to which sick people should 

 come for expert treatment. In appearance, these medical centres 

 present a striking contrast to British provincial hospitals. At first 

 sight there appears to be a lack of order and cleanliness. The fami- 

 lies of patients live in the hospital compound and produce all the 

 patient's food themselves. The wards are long low buildings, 

 divided off into separate chambers, in each of which there may be 

 several sick people lying on mats and covered only by blankets, 

 living with their wives and children. Well over lOO in-patients 

 are so disposed. Out-patients to the number of 350 or more in a 

 day are examined by the military doctor and his native auxiliary. 

 Such conditions might drive the staff of a British hospital to resig- 

 nation, but the enormous number of patients indicates the popu- 

 larity of the French system. This type of medical attention, though 

 greater in quantity, is probably inferior in quality compared with 

 the British. The latter system may be described as seeking to per- 



