co6 SCIENCE IN AFRICA 



There are thus two aims in medical education in Africa: first 

 to produce auxiliary doctors to form the middle of the pyramid, 

 for which the system of training must be based on that well-proved 

 in European countries; second to produce the dispensers, nurses, 

 dressers, and other subordinates at the base of the pyramid. For 

 the first type it is obvious that special medical schools are essential, 

 but for the second, training facilities can be made available at 

 hospitals, though special schools are of value for the higher grades 

 such as dispensers, mid wives, and sanitary inspectors. The train- 

 ing of auxiliary doctors should of course have in view the eventual 

 appointment of the ablest to senior posts. There must, however, 

 be an intermediate stage in which partially, as opposed to com- 

 pletely, trained men serve in positions where considerable super- 

 vision by superior officers is exercised. This partial training is 

 often opposed by the medical profession, but it is coming into 

 prominence in several parts of the world. In Central Europe the 

 Felcher System is already under trial: partly trained doctors are 

 returned to peasant villages where they usually marry and some- 

 times combine a small practice with some other occupation. A 

 similar system is being developed in India, and is contemplated in 

 China and Japan. 



The systems of training in Africa have been surveyed by Buell 

 (1928), and more recently Dr. C. C. Chesterman (1932) has out- 

 lined the practice of Sierra Leone, the Gold Coast, Nigeria, the 

 Sudan, Uganda, Tanganyika, Nyasaland and the Belgian Congo. 

 He advocates many small schools, since these have the advantage 

 of personal contact between teacher and student. The most recent 

 survey of facilities for medical training in East Africa is given in 

 the report of the Commission on Higher Education in East Africa 

 published in September 1937. 



AUXILIARY DOCTORS 



The centres where auxiliary doctors are now trained number 

 five; the medical schools at Dakar, which provides medecins auxi- 

 liaires for all French West Africa, at Yaba near Lagos in Nigeria, 

 the Mulago Medical School at Kampala in Uganda, the Native 

 College at Fort Hare in South Africa and the Kitchener School of 



