A century has passed since Albert Schweitzer first worked as a missionary doctor on the edge of the primeval forest, in Gabon. This first book about his experiences there was published in 1922 when he was back in Europe on furlough; part autobiographical, more a mixture of memoirs and musings, this book and its sequel1 inspired me to emulate the great man in service to needy people in another country. It was his motivation which first gripped my imagination:
‘I had read about the physical miseries of the natives in the virgin forest ... and the more I thought about it the stranger it seemed to me that we Europeans trouble ourselves so little about the great humanitarian task which offers itself to us in far off lands …’ he says in the first chapter.
As a teenager, I first heard of Albert Schweitzer about the time of his death (at age 90, in 1965), and I identified with his feeling that ‘I have been so privileged in having health and good education, I must give something back to the world.’ Later I matched this idea with instructions from Jesus to his emissaries: ‘Freely you have received, freely give.’ 2 When my parents gave me this book, they recognised a risk that their daughter would also become a missionary doctor if she obtained a place at university to study medicine!
Dr Schweitzer was a theologian and philosopher, but also an accomplished musician, so his friends were surprised when, (already 30 years old) he began to study medicine in preparation for work in Africa. When living in primitive conditions he found the philosophy books and the organ he had taken with him to be a pleasurable alternative occupation after a tiring day’s work in the hospital. This would have been even more important in later times when, due to illness, his wife was unable to be with him in Africa.
He was very much a man of his times and although a consistent compassion for the local people shines through his writings and his generous practical assistance to them (in the form of medical care) was highly-valued, long passages of this book reveal a deeply-rooted belief in the superiority of the European, which to our modern minds is unacceptable. He railed against what he saw as the unjust exploitation of African people by ‘colonials’ and traders, he himself tried to treat his employees fairly, but he repeatedly describes local people as unreliable and reluctant to do hard work. His observations on their behaviour may have been true, but how much of this so-called ‘apathy’ was due to their different cultural expectations and their chronic ill health is hard to say at this distance of time. One comment of his (regarding the labour issue) with which we might agree: ‘The tragic element in this question is that the interests of civilisation and of colonisation do not coincide but are largely antagonistic to each other.’
The descriptions of illnesses he treated make fascinating reading: in particular the tragic ‘sleeping sickness’ (a vector-borne parasitic disease) so common at that time (having been introduced to the area 30 years before) was a condition for which he had medicine (atoxyl, an arsenical) but which he could not always cure: chapter 5 gives a graphic account of the natural history of the untreated disease of which the cause and transmission had been elucidated only 10 years earlier.
In view of my own later experiences, when I recently re-read the book I was interested to see what he said about leprosy: ‘The only drug we have at our disposal for fighting this disease is Chaulmoogra oil … it is expensive and usually comes into the market adulterated …. A real cure for leprosy is beyond our powers but a great improvement in the patient’s health can be effected …’
In later years, Dr Schweitzer was awarded a Nobel Peace Prize. Besides the medical services rendered in Africa, after the Second World War ‘... people who knew about the diabolical effects of atomic radiation began increasingly to see him as a valuable champion of their cause against the ambition of politicians and the apathy of the public.’3
This is a book worth reading again and again. It bears testimony to an unselfish man whose life’s work brought health and benefit to many hundreds of poor people who had, at that time, no other source of effective help for their many illnesses. It presents valuable information for the medical historian or student of tropical epidemiology. It can also help us to understand the social situation in early 20th century Western Africa which was the background for the later political development of those countries.
- © British Journal of General Practice 2016