[News] Why Africa Fears Western Medicine

[Anti-Imperialist News]

http://www.iht.com/articles/2007/07/31/opinion/edwashington.php

Op-Ed Contributor
Why Africa Fears Western Medicine

By HARRIET A. WASHINGTON
Published: July 31, 2007

TO Westerners, the repatriation of five nurses 
and a doctor to Bulgaria last week after more 
than eight years’ imprisonment meant the end of 
an unsettling ordeal. The medical workers, who in 
May 2004 were sentenced to death on charges of 
intentionally infecting hundreds of Libyan 
children with H.I.V., have been freed, and 
another international incident is averted.
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Anthony Russo

But to many Africans, the accusations, which have 
been validated by a guilty verdict and a promise 
to reimburse the families of the infected 
children with a $426 million payout, seem 
perfectly plausible. The medical workers’ release 
appears to be the latest episode in a health care 
nightmare in which white and Western-trained 
doctors and nurses have harmed Africans — and have gone unpunished.

The evidence against the Bulgarian medical team, 
like H.I.V.-contaminated vials discovered in 
their apartments, has seemed to Westerners 
preposterous. But to dismiss the Libyan 
accusations of medical malfeasance out of hand 
means losing an opportunity to understand why a 
dangerous suspicion of medicine is so widespread in Africa.

Africa has harbored a number of high-profile 
Western medical miscreants who have intentionally 
administered deadly agents under the guise of 
providing health care or conducting research. In 
March 2000, Werner Bezwoda, a cancer researcher 
at South Africa’s Witwatersrand University, was 
fired after conducting medical experiments 
involving very high doses of chemotherapy on 
black breast-cancer patients, possibly without 
their knowledge or consent. In Zimbabwe, in 1995, 
Richard McGown, a Scottish anesthesiologist, was 
accused of five murders and convicted in the 
deaths of two infant patients whom he injected 
with lethal doses of morphine. And Dr. Michael 
Swango, ultimately convicted of murder after 
pleading guilty to killing three American 
patients with lethal injections of potassium, is 
suspected of causing the deaths of 60 other 
people, many of them in Zimbabwe and Zambia 
during the 1980s and ’90s. (Dr. Swango was never tried on the African charges.)

These medical killers are well known throughout 
Africa, but the most notorious is Wouter Basson, 
a former head of Project Coast, South Africa’s 
chemical and biological weapons unit under 
apartheid. Dr. Basson was charged with killing 
hundreds of blacks in South Africa and Namibia, 
from 1979 to 1987, many via injected poisons. He 
was never convicted in South African courts, even 
though his lieutenants testified in detail and 
with consistency about the medical crimes they conducted against blacks.

Such well-publicized events have spread a fear of 
medicine throughout Africa, even in countries 
where Western doctors have not practiced in 
significant numbers. It is a fear the continent 
can ill afford when medical care is already hard 
to come by. Only 1.3 percent of the world’s 
health workers practice in sub-Saharan Africa, 
although the region harbors fully 25 percent of 
the world’s disease. A minimum of 2.5 health 
workers is needed for every 1,000 people, 
according to standards set by the United Nations, 
but only six African countries have this many.

The distrust of Western medical workers has had 
direct consequences. Since 2003, for example, 
polio has been on the rise in Nigeria, Chad and 
Burkina Faso because many people avoid 
vaccinations, believing that the vaccines are 
contaminated with H.I.V. or are actually 
sterilization agents in disguise. This would 
sound incredible were it not that scientists 
working for Dr. Basson’s Project Coast reported 
that one of their chief goals was to find ways to 
selectively and secretly sterilize Africans.

Such tragedies highlight the challenges facing 
even the most idealistic medical workers, who can 
find themselves working under unhygienic 
conditions that threaten patients’ welfare. 
Well-meaning Western caregivers must sometimes 
use incompletely cleaned or unsterilized needles, 
simply because nothing else is available. These 
needles can and do spread infectious agents like 
H.I.V. — proving that Western medical practices 
need not be intentional to be deadly.

Although the World Health Organization maintains 
that the reuse of syringes without sterilization 
accounts for only 2.5 percent of new H.I.V. 
infections in Africa, a 2003 study in The 
International Journal of S.T.D. and AIDS found 
that as many as 40 percent of H.I.V. infections 
in Africa are caused by contaminated needles 
during medical treatment. Even the conservative 
W.H.O. estimate translates to tens of thousands of cases.

Several esteemed science journals, including 
Nature, have suggested that the Libyan children 
were infected in just this manner, through the 
re-use of incompletely cleaned medical 
instruments, long before the Bulgarian nurses 
arrived in Libya. If this is the case, then the 
Libyan accusations of iatrogenic, or 
healer-transmitted, infection are true. The acts 
may not have been intentional, but given the 
history of Western medicine in Africa, 
accusations that they were done consciously are far from paranoid.

Certainly, the vast majority of beneficent 
Western medical workers in Africa are to be 
thanked, not censured. But the canon of “silence 
equals death” applies here: We are ignoring a 
responsibility to defend the mass of innocent 
Western doctors against the belief that they are 
not treating disease, but intentionally spreading 
it. We should approach Africans’ suspicions with 
respect, realizing that they are born of the acts 
of a few monsters and of the deadly constraints 
on medical care in difficult conditions. By 
continuing to dismiss their reasonable fears, we 
raise the risk of even more needless illness and death.

Harriet A. Washington is the author of “Medical 
Apartheid: The Dark History of Medical 
Experimentation on Black Americans From Colonial Times to the Present.”






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