One problem I’ve been seeing about PC health missions in Africa is the problem of convincing people of preventative measures. People don’t want prevention; they want a cure to the horrible parasite infecting them now. Malaria avoidance takes a back seat to chloroquine injections to cure it now.
In order to understand this, first let’s look at West African society. West Africa has a lot of bugs and little food with little protein. Death rates are high and often people have to work the whole day long to be able to eat. Of course a society like that is going to prize the present day. Saving up for tomorrow only makes sense if (a) you have enough to save up, and (b) there’s a reasonable chance you’ll make it to tomorrow. When resources are scarce and life uncertain, by contrast, societies are going to value activities that celebrate the present. I say this to underscore how material conditions affect what people value, and that it makes sense if one puts oneself in their position.
But more than that, let us not forget that preventative health did not immediately catch on in the West. When it was suggested that washing hands would cut down fatality rates in hospitals, doctors laughed! It took a while for modern medicine to catch on in the West. When you really look at it, you could go back to the Greeks, to Aristotle’s observational skills, the work of classical and medieval physicians such as Galen, Avicenna, and Maimonides, the rise of Aristotelianism, nominalism, and mechanical physics, the discovery of germs, and then the further scientific research to get to where we are today. It took our society millenia to discover this stuff; why should it be introduced elsewhere in a single generation?
When you think about it, putting aside modern education on the germ theory of disease, hand-washing does seem like an almost magical ritual. Why should it work? And even now, most people do not take advantage of preventative medicine, but wait until they are sick. Hand-washing is really a magical ritual for most, and vaccines taken because required.
Things take time, and the problem of introducing new medical practices hits against a certain inertia in human nature that we see at home just as much as overseas. I do not plan to go to change the world. I hope to make a difference in one or two lives. They can impact a couple more, and from there more, until in a few hundred years there is health and education throughout the region. I would like to see it done now, to be sure, but (1) societies change over generations, and (2) the real change needs to come as an African response to African needs, and not some middle-class white boy telling them what they need. I go to offer tools I find useful and that I think are useful to human beings in general, and hope that they will actually be so.