HEALTH AND MEDICINE GENERAL 5O3 



1923 the advance in medical work in Angola has been notable, 

 and a hospital and dispensary system is now established. In 1935 

 there were 15 hospitals, with 65 doctors and some European assis- 

 tants. Special courses of training are held for native nurses and 

 other subordinate staff. In Angola the Baptist Missionary Society 

 (London) and several American missions support about eight hos- 

 pitals, each with a doctor and most with a nurse in addition. 

 The Baptist centre at San Salvador trains native medical assistants 

 and nurses. 



PAYMENT FOR MEDICAL SERVICES 



Throughout Africa, as in other parts of the world, certain 

 government servants receive free medical attention; non-officials 

 are expected to pay for it when they can afford it, and private 

 practitioners charge fees according to the usual system. The 

 question whether government doctors should be entitled to under- 

 take private practice has accordingly arisen. This is allowed in 

 many areas but it is the policy of the Colonial Office eventually 

 to prohibit it. 



Practice as regards charging fees to African patients varies in 

 different territories. In the French colonies payment is asked only 

 in exceptional cases where patients can obviously afford it, al- 

 though in Togo under French Mandate there is a scale of charges 

 for treatment. It must be remembered, however, that under the 

 French system the food and clothing are not provided for hospital 

 patients. In the Belgian Congo under the State Medical Service 

 free treatment is given except for accidents and most surgical 

 cases, when some payment is expected from patients who can 

 afford it, as a contribution towards the cost of the materials used 

 for their treatment. No fees to doctors are paid by natives. Where- 

 ever possible the relatives of hospital patients are expected to con- 

 tribute food for their support. 



In most of the British colonies the majority of natives receive 

 attention free. In some, small charges are made for supplying 

 medicines, etc. This policy has been adopted especially in Uganda, 

 except in the cases of notifiable infectious disease or of indigent 

 persons and expectant mothers who are always treated free, and 



