TY - JOUR T1 - Lessons from history: primary care at Yakusu in the Belgian Congo, 1921–1960 JF - British Journal of General Practice JO - Br J Gen Pract SP - 186 LP - 187 DO - 10.3399/bjgp20X709109 VL - 70 IS - 693 AU - Gervase Vernon Y1 - 2020/04/01 UR - http://bjgp.org/content/70/693/186.abstract N2 - In the UK, primary care is delivered largely through general practice. By looking at the slow rise and rapid fall of another system of primary care, set in the ‘Province Orientale’ of the Congo, at Yakusu, between 1921 and 1960, can we learn something about our own system of general practice?The early years of the colonisation of the Congo, until at least the 1920s, saw a decline in population, whether due directly to the notorious brutality of Leopold’s early rule or, more likely, the spread of diseases through a now much more mobile population.1,2 The disease that most captured the attention of the Belgian colonial authorities was sleeping sickness (trypanosomiasis). They instituted, from the early days of Leopold’s rule, a draconian ‘vertical health programme’ directed against it.3 Those diagnosed were forcibly incarcerated and treated with atoxyl, which was an arsenical, effective against trypanosomiasis, but causing 2% to 30% blindness. By the 1930s, a safer arsenical, tryparsamide, was used and mass treatment of human cases turned … ER -