We need about 10,000 or more of us to indeed find time to read and write about Africa. We need that critical narrative by Africans about Africa and the World. Sometimes I wonder if the term "poor" has not corrupted some of us into complacency. Uplifting words have prophetic and catalytic empowerment.
While in Uganda, I mostly worked in the regional health districts, urban areas, on the big islands, rural areas and in emergency situations like the two Ebola episodes we had. I saw more pyrexia of unknown origin, idiopathic, neurological, trauma, mental health, physiotherapy and psychological cases that went unaddressed. It is no wonder that many patients see our hospitals or clinics as "death destinations that need not be embarked upon."
Medicalizing medicine and the practicing of medicine in Uganda (perhaps in Africa too) have created power structures. I have closely followed African country-based health outputs as far as the Millennium Development Goals/Sustainable Development Goals go. I have written comparison reports and shared with people from other continents.
I am a member of the International AIDS Society and Africa AIDS Society. In those capacities, it is my opinion that integration is the way to go. A change of mindset was due by 1970. This means we have to redefine our sense of health by imagining a spectrum. At one extreme, we should have any parameter defining a condition e.g., maternal mortality. At another end we can have wellness measures such as how many people are able to afford full antimalarials; have shuttered (with good ventilation, windows and doors) homes; can afford to control or avoid mosquito bites and other aspects.
Health is so immediate a context and we need to define the good and problematic parameters equally if we are to talk of progress. It comes as no surprise when it stirs different emotions and criticisms. Who wouldn't want want first class care? We need to combine the medical and social aspects, evidence-based medicine and contextualize the belief models experienced by Africans. Hospitals or clinics should not be shaming spaces for patients who want to take the after-birth back with them and place it at a sacred place in their home gardens. We should look into the patterns of African empathy and how these add to the numbers of people who visit loved one in the hospitals. We should use statistical reports to predict trends in demand and supply. We can motivate health workers through provision of better work conditions, task shifting and proper housing. We may have solutions to overcrowding, drug stock-outs and absenteeism.
Lastly, I still think in place of words like "poor" or "backward," we can actually borrow from social science research or theories and contextualize African situations in a more proactive way with a goal of upliftment. I posit the following adjectival epithet: "low resource context countries" instead of "poor." Thanks for adding a narration to what matters in Africa and other low resource context countries.