Millar 1

Gloria Millar

Medical Missions in Tanzania

For centuries Christians have been recognized by their efforts in helping the sick and

poor. Besides saving man’s soul, Jesus’s ministry on earth was characterized by multiple

accounts of healing man’s body. In Matthew 10:8, Jesus tells his disciples to “heal the sick…”

and in Proverbs 31:9 we are commanded to “…defend the rights of the poor and needy.”

Religious organizations have sent out medically trained women and men in response to Jesus’s

calling for hundreds of years. Whether pioneering acute care or primary care, medical missions

have generally led the changes of medical knowledge and practice.1 However, over the history of

medical missions, there have been many significant transformations. In studying medical

missions, it is important to acknowledge two relationships that have been fundamental in the

shifting focuses. The first connection is between the Church and the Government; the second

being between the missionaries and people they are serving. Because these two relationships

began to transform in the 1960s, this decade can be marked as the pinnacle of medical missions

in Tanzania in terms of usefulness. Through Dr. Birney Dibble’s memoirs, a reader is able to

observe these shifts in his hospital and in his relationships with the Tanzanian people. However,

to accurately perceive these transformations, it is necessary to understand the history of medical

missions in Tanzania.

In pre-colonial Africa, before the people were influenced by foreigners, Tanzanians relied

on witchdoctors, herbalists, and medicine men for their health care. Based on current traditional

practices, T.W.J. Schulpen, who studied the functionality of integrated hospitals beginning in

1
John Greenall, “What is the future of medical mission?” Nucleus, (2016): 6-10.
 Millar 2

1969, has inferred how medical care was delivered before the arrival of Europeans. The people

believed that a person’s health was affected by the harmony of the human life force. For

instance, if a person became sick, it was accredited to him engaging in taboo activities or

neglecting to perform sacrifices. In order to be healed, he would go to either a medicine man,

herbalist, or witchdoctor who would then diagnose the cause of the disrupted harmony and treat

him with medicines. The most trusted were the medicine men. A medicine man would tend to at

least fifteen households; he had personal relationships with each person which created an

atmosphere of trust between them.2 Eventually, more developed practices would be introduced in

Tanzania, or Tanganyika as it was called until 1964.

With the arrival of foreigners came new ideas about health. The first factor to influence

traditional healing was the establishment of an Arabian population. Although the Arabians had

some medical knowledge based on scientific aspects and the potential to advance surgical

procedures, most of the introduced ideas were also based on the supernatural. The Koran was

used by African healers as a new source of information; the words used in the Koran for angels

and spirits were believed to give power.3 Although the Arabs were present in East Africa, they

would not be a significant component in the development of medicine or missions.

The Western missionaries that came next would remain prominent throughout African

history. The majority of the first missionaries to arrive in Tanganyika were evangelistic, however

there were some medical missionaries. These medical missionaries brought with them the first

Western medical knowledge. For themselves the medical missionaries brought medicine to

2
T.W.J. Schulpen, Integration of Church and Government Medical Services in Tanzania. Effects at District Level,
(Nairobi, Kenya: African Medical and Research Foundation, 1975), 37-38.
3
Schulpen, Integration of Church and Government, 38.
 Millar 3

prevent malaria. This newly introduced powerful Western medicine impressed many local tribe

leaders; consequently medical missionaries earned respect and a reputation of miraculous healing

from the perspective of the indigenous people. One of the main focuses of these early medical

missionaries, especially of the Holy Ghost Fathers, was the care of freed slaves. Large amounts

of Western medicine were imported for this cause. The influx of foreign medicine upset many

local healers. However, medical missionaries only gained popularity through their treatments and

successful, albeit small, surgical procedures.4

Soon the focus of medical missionaries expanded from freed slaves to caring for their

own missionaries who were dying. The first doctor commissioned to care for sick missionaries

was Dr. Baxter of the Church Missionary Society. He moved to Tanganyika in 1874; soon others

moved into Africa with the same purpose.5 During the pre-colonial era, there was no relationship

between the Church and any form of African government beyond the local tribe leaders being

impressed with the missionaries’ skill. The medical missionaries tended to a small population-

freed slaves and sick European missionaries, so the relationship between medical missionaries

and the people they served was very limited.

The next period in Tanzanian history is from 1885-1918, when Germans controlled the

region. During this stage, government hospitals were built for the first time. Free treatment was

given to government employees and the poorest members of the community. Private

practitioners soon arrived for the treatment of Europeans. German army doctors were charged

with the duty of traveling throughout the country and caring for the people; their main goals were

4
Schulpen, Integration of Church and Government, 38-39.
5
Schulpen, Integration of Church and Government, 40.
 Millar 4

to protect the health of the European community, prevent endemics from spreading, and preserve

the health of the African work force. Besides subduing the outbreak of tropical endemics, most

of the care was solely for the benefit of the Germans.6 Because the medical missionaries were

already familiar with tropical diseases present in the region, government officials consulted with

the Church.

For the typical Tanzanian, mission hospitals provided the most care. Located mainly in

rural areas, missionary doctors recognized the need to provide health care to local people. Priests

and religious sisters managed the hospital and treated the patients. However, they were untrained

beyond one introductory course required during their novitiate. Furthermore, there was not even

a qualified doctor or nurse to oversee the operations.7 Despite being insufficient in medical

knowledge, the medical missionaries were dedicated to their mission of healing body and soul.

At the time, there were three religious organizations present in Tanzania- Muslims,

Roman Catholics, and Protestants. The Muslims are irrelevant in this discussion because they

were not involved in any organized health services. The Roman Catholic Church and the

Protestant Church were the main providers of missionary care. However, there was competition

between the two, and there would be for many more decades. Competing hospitals were

established across the street from each other and offered the same services.8 Eventually, the

Roman Catholic Church and the Protestant Church would unify to provide more effective care

for the indigenous people. When World War I began, government nurses and doctors were

enlisted; the Government had to rely on the Church, both Roman Catholic and Protestant, to

6
Schulpen, Integration of Church and Government, 40-42.
7
Schulpen, Integration of Church and Government, 42-43.
8
Schulpen, Integration of Church and Government, 43.
 Millar 5

provide the health services that they were unable to.9 The relationship between the Government

and the Church would continue to grow through the next stage of Tanzanian history. The

relationship between the missionaries and the indigenous people was becoming stronger as they

relied mainly on the missionary hospitals. However there was still a strong undertone of cultural

superiority and paternalism which would continue to exist during the British period.

From 1919-1961, the British controlled Tanganyika. This was a period of growth in the

medical field. European doctors filled the vacant positions in hospitals. This time hospitals were

staffed with civilian doctors and nurses. The government officials recognized the need to expand

hospital services so the local chiefs were asked to develop dispensaries in rural areas.

Dispensaries were different than hospitals in that they were managed by Africans rather than

Europeans or Americans. Missionary and government doctors walked up to fifty miles to check

on the dispensaries. The dispensaries were paid for by taxes so that costs would be lowered and

therefore services would be more available to the indigenous people.10 The faculty at mission

hospitals increased as well. A graph describing the medical activities of the Universities’ Mission

to Central Africa diocese of Masasi shows a steady increase in doctors, nurses, African

assistants, hospitals, dispensaries, in-patients, and out-patients from 1932-1939.11 With

expansions of staff, clinics, and patients there was an obvious increase in medical work.

At this time, the evangelistic missionaries were trying to teach the indigenous people that

polygamy was a sin. Many Africans refused to convert because they were unwilling to renounce

polygamy. In order to convince the Tanzanians that a person could have just as many kids

9
Schulpen, Integration of Church and Government, 43-44.
10
Schulpen, Integration of Church and Government, 44-47.
11
Schulpen, Integration of Church and Government, 48-49.
 Millar 6

through one marriage, the medical missionaries began to introduce maternity and infant care.

Because the government officials wanted to reduce the high infant mortality rates, the medical

missions were supported through government funding. According to the Annual Report Medical

Department in 1929, nearly twice as many mothers and children attended a missionary clinic

than a government clinic.12 Once again, it is evident that mission hospitals were more available

to the indigenous people and the Government relied on the Church to provide health care to the

rural populations.

The competition between the Protestant and Roman Catholic Church remained. The

Protestant Church was progressive in terms of training the indigenous people. From the

beginning of the British occupation, Protestant missionaries were focused on training auxiliary

staff. Next, mission hospitals began training hospital assistants through a four year course. Soon

afterwards, nurses’ training schools were opened. By this time, the Roman Catholic Church had

just begun to provide a training course.13 Years later the Roman Catholic Church would become

focused on spreading their religion and less concerned with the present human conditions. The

Protestant Church, however, would consistently use medical missions as an evangelism tool.14

By the end of the 1960s the Government would control most health care services, so the

Protestant and Roman Catholic Churches would have to coordinate to provide health care

effectively.15

Although the Government and Church worked well together when they wanted to reduce

infant mortality and train indigenous people, tensions began to rise. Both organizations wanted

12
Schulpen, Integration of Church and Government, 49-50.
13
Schulpen, Integration of Church and Government, 51-53.
14
Schulpen, Integration of Church and Government, 91-92.
15
Wall, Into Africa, 125-130.
 Millar 7

recognition for their efforts. The Government wanted to be acknowledged for the sake of

strengthening the economy. The Church wanted recognition to spread their religion. The

relationship between the missionaries and the indigenous people was beginning to deepen as the

missionaries gave more responsibilities to the Tanzanians. Beginning by providing individual

training for auxiliary staff to establishing training schools, the goal was that the indigenous

people would be able to sustain themselves eventually.

The final period before the major shifts between the Church and Government and the

missionaries and indigenous people, was when Tanzanian gained independence in 1961.

Following independence, Chiefdoms were abolished and replaced with elected officials. The

newly established government immediately introduced a three-year development plan.

Unfortunately the budget was not sufficient to adequately support much needed developments.

The government officials allotted the majority of the budget, 60 percent, to economic projects.

Education programs were granted 15 percent of the budget. And although the government

officials recognized the nation’s responsibility to provide health care, health services only

received 4 percent. Of that amount, a large portion was utilized for curative medicine in urban

hospitals.16 That left most of the rural clinics operated by missionaries. The missionaries’ efforts

were eventually recognized and rewarded with the implementation of the grants-in-aid scheme.

This development gave much needed funding to the mission hospitals but it also allowed the

Government to have more control on the hospital’s operations.17 The Government and the

Church had separate responses the Tanzanian independence.

Not off to a great start, only 4%

16
G.M. van Etten, Rural health development in Tanzania, (Nijmegen: Van Gorcum & Comp. B.V., 1976), 38.
17
Schulpen, Integration of Church and Government, 54.
 Millar 8

In 1964, after the three-year plan, government leaders implemented the First Five-Year

Development Plan. Based on the ideas of Dr. E Pridie, a Chief Medical Advisor to the Colonial

Office, the medical plan focused on providing curative care, training Africans, de-centralizing

services, and standardizing fees.18 Until the 1960s, hospital fees varied from maize to cash and

depended on socioeconomic factors. By 1969 it was obvious that not all of the objectives had

been met; this is due possibly to the unexpectedly fast population growth, the decrease of foreign

aid that had been available while the British were ruling, and the focus on building new hospitals

rather than improving existing ones.19 However, some of the smaller goals that were realized,

such as more hospital beds, expansion of dispensaries, improved care for tuberculosis and

leprosy patients, and increased training for indigenous people, could be attributed to the efforts

of medical missionaries.20

Although not in direct relation to Tanzania, it was in the early 1960s that medical

missionaries in Tanzania responded to the call of the Second Vatican Council. Barbra Mann

Wall studied the influence the Vatican II, as it was popularly called, had on the Roman Catholic

missionaries and their service to the people at a local level. The personally convicted religious

sisters rewrote their constitutions and reevaluated their mission goals. In Tanzania specifically,

the Maryknoll Sisters, changed their primary purpose of converting “pagans” to serving the poor.

Although they were still invested in spreading their religion, they believed that they would be

able to do so more effectively by building personal relationships and witnessing through their

actions. To identify with the Africans, the Sisters shed their religious clothing and donned local

18
Schulpen, Integration of Church and Government, 55-66.
19
Van Etten, Rural Health, 41-42.
20
Schulpen, Integration of Church and Government, 65-66.
 Millar 9

clothing. They felt called to be with the people, so they moved out of their mission stations.

When they were not working in the hospital they worked in the fields with the indigenous

people.21 This transformation sparked a new relationship between the missionaries and the

indigenous people. It allowed the missionaries to relate and build trust among the people. Most

importantly, it provided opportunities for the missionaries to learn from the Africans.

Dr. Birney Dibble provides a primary source of information where a reader can observe

medical missions in Tanzania during the 1960s. When Dibble, the son of a minister and nurse,

was in high school he decided he wanted to be a missionary doctor. To pay for college, Dibble

joined the Navy. He gained valuable experience while he served his time during the Korean War.

After he was relieved, he and his wife began to look for missionary opportunities but because his

wife did not have a college education, they were dismissed. Dibble and his family lived in

Wisconsin where he opened a private practice.22 Years later, Dibble’s colleague told him about

the extreme lack of doctors in Kiomboi, Tanzania. After talking to his wife, Dibble and the

family moved to Tanzania. Although they had a Methodist background they passed the required

Lutheran-orientated examinations and were stationed at the Kiomboi Lutheran Hospital where

they spent a total of three years.23 Their time was divided in two visits; the first from 1962-1962

and the second from 1967-1968.24

21
Barbra Mann Wall, Into Africa: A Transnational History of Catholic Medical Missions and Social Change, (New
Brunswick: Rutgers University Press, 2015), 64-92.
22
J. Birney Dibble, interview by Lynnita Brown, Korean War Educator, Sept. 18, 1999.
23
J. Birney Dibble, This Land of Eve: A Year with an American Surgeon in East Africa, (New York: Abingdon Press,
1965).
24
J. Birney Dibble, the Plains Brood Alone: Tribesmen of the Serengeti, (Grand Rapids, Michigan: Zondervan
Publishing House, 1973).
 Millar 10

While Dibble’s memoirs are primarily about the people he met and the work he did,

Dibble briefly mentioned the state of government affairs during his first visit immediately after

independence. He noted that one of the biggest concerns is that individuals do not think for

themselves. Instead elders, families, and communities must make decisions together. While this

can be good, Dibble observed that the African community needed to start making executive

decisions or else the country risked remaining undeveloped.25 Dibble believed that “an

unfortunate tendency for many Africans is to blame all their troubles on the white man, despite

the fact that of the thousands of years of their existence, the white man has been in Africa in a

ruling capacity for a mere half-century.”26 Dibble acknowledged the tinge of racism within the

Tanzanian community. Save for his encounter with the Barabaig tribe who felt superior to the

white man as well as fellow Africans, Dibble did not experience any personal grudges due to his

race.27 However, he did notice that as he improved in his Swahili skills, the comradery between

him and the African staff also improved. Fellow missionaries told him that by learning the local

language he proved that he wanted to unify with the indigenous people.28

Through his accounts, readers can observe the relationship between a medical missionary

and the indigenous people. When he was not in the hospital, Dibble spent his time traveling,

hunting, and building personal relationships with the people he met. Dibble reflected on his time

spent with the Iramba tribe in particular and what he learned from them. Kiomboi is near the

center of the Iramba Plateau where the Iramba tribe reside. Compared to other tribes, Dibble

noted that the Iramba tribe was more advanced. Because of previous attempts made by British

25
Dibble, This Land of Eve, 50-51.
26
Dibble, This Land of Eve, 52.
27
Dibble, This Land of Eve, 121.
28
Dibble, This Land of Eve, 42-43.
 Millar 11

colonists to educate the Iramba tribe, their rate of literacy was higher than others. Since the

colonists have left, much of the education was provided entirely by the missionaries. Considering

that their knowledge was more progressive, the members of the tribe had a more enlightened

view of medical practices. Despite the older generation being suspicious of Western medicine,

the majority of the people recognized that the missionary doctors could heal because they have

been educated and trained. However, there were still deep-rooted superstitions about health. For

instance, Dibble noted beliefs about delivering babies, such as the reasons for birth defects or the

customs following the birth of twins. As well as the assumption that malaria, tuberculosis, and

mental illness were caused by curses. Some still believed that leprosy was punishment for

stealing. It is important to highlight that the older generation had a more difficult time trusting

Western medicine. The younger generation was more open to Western medical knowledge. For

example, the younger generation recognized gonorrhea as a contagious disease causing sterility,

while the older generation refused to reject their traditional beliefs about what caused sterility.

Ultimately, Dibble wanted to learn about the local traditions and beliefs so that he could better

treat his patients and begin to dispel harmful superstitions.29

In Dibble’s diary entries and stories the reader is provided with an accurate depiction of

how a mission hospital was managed in the 1960s. During his first visit in 1962, Dibble worked

closely with Godson Mangare, a Medical Assistant who was trained in a three-year course at

Bumbuili. Dibble relied on Mangare for his knowledge of local issues and tropical diseases.

Dibble compared medical assistants at Kiomboi to interns in American hospitals. Dibble noted

that the medical assistants were extremely helpful and hadgreat potential, but most of them did

not have the opportunity to complete the gaps in the medical knowledge. Also necessary to the

29
Dibble, This Land of Eve, 45-50, 89-98.
 Millar 12

functionality of the hospital were the staff nurses; some, like Elisifa Shani, were trained at the

Kiomboi Nurses Training Centre. Sister Greta Engborg managed the midwives which were

crucial to the operations in Ward D which was specific to obstetrics. Dibble began each workday

by being escorted in every ward by the staff nurses who would brief him on the condition of the

patients. Afterwards, Dibble would work on specific cases ranging from examinations to trauma

surgery.30 During the weekends, Dibble and other staff members traveled to dispensaries to

provide health care to more primitive or rural tribes.31

Dibble recounts a visit to one dispensary in particular. Located in the valley of the

Barabaig there is a mission station consisting of a dispensary, church, school, and home for the

medical missionaries Hal and Louise Faust. Here Dibble relied on Marko, a Christian Barabaig,

to be his translator while working with the members of the Barabaig tribe. Dibble observed that

Marko was an essential player in at the mission station; Marko could spread Christianity in a way

that Hal and Louise could not. Since he was a member of the Barabaig tribe, he was respected

and listened to. Marko is a good example of how even though the indigenous people were being

helped by the missionaries, they would benefit more from other indigenous people than from

foreigners. Although he was not trained, he was an important figure in the functionality of the

mission station.32

In Dibble’s second book, The Plains Brood Alone, he describes the development of the

Kiomboi Mission Station since 1963. Not even five years later and the hospital had been

remodeled. A new structure had been built and then dedicated by Tanzanian President Julius

30
Dibble, This Land of Eve, 25-42.
31
Dibble, This Land of Eve, 118-128.
32
Dibble, This Land of Eve, 122-125.
 Millar 13

Nyerere. Since then, medical assistants had private consultation rooms, there was a separate

labor ward, new operating rooms, more patient rooms, and windows so that fresh air was

accessible from every room. Not only had the physical hospital changed, but the management of

the hospital as well. Nearly every available position was staffed by African personnel. Only

missionaries held positions that the Tanzanians were unqualified to fill. The intention was that

eventually Kiomboi Hospital would be entirely managed by indigenous people. In fact, by 1969

the first African doctor would be hired. Beginning in 1970, the hospital would become a

Government hospital; until then, the hospital was given a yearly grant so that the patients would

receive free services. In Dibble’s opinion the entire atmosphere had changed for the better; he

attributed that change to the fact that he Kiomboi Lutheran Hospital was not just a foreigner’s

hospital anymore.33 It was becoming integrated with the indigenous people and with the

Tanzanian Government.

After achieving independence, there was an effort to integrate mission hospitals with the

Government. In 1963, Dibble met with a student from the University of Minnesota who was in

Kiomboi studying the sociological aspects of medical practice. The student shared his concerns

with Dibble. He had been given conflicting information from various sources and was not sure

how to interpret it. Dibble told the student that he probably only had part of the truth. In fact,

even though there were efforts to “governmentalize” the hospitals, at the time missions were still

providing about half of the health care.34 The government officials could not afford to disturb the

mission hospitals. Instead, in order to remain involved, the Government helped fund the

hospitals. By November 1969, after four years of negotiations, the first fully integrated hospital

33
Dibble, The Plains Brood Alone, 13-15.
34
Dibble, This Land of Eve, 64-65.
 Millar 14

was finally established. It was built and equipped by the Church but the Government was

financially responsible. The hospital was managed by three Church and two Government

representatives and was staffed by both missionaries and government employees.35 This was the

first hospital of many to come, including the Kiomboi Lutheran Hospital36.

More major changes occurred during the 1960s than in previous decades. Government

hospitals began to become more popular; this could be attributed to less expensive fees and

growing availability. There was the key shift of providing mainly acute care to preventative

services. The continuous need to train indigenous people was being seriously acknowledged by

the Government as well as the Church.37 In fact after Vatican II and the subsequent

transformation of mission goals, many missionaries were not concerned about losing their

religious identity. Their main focus was to serving the people that needed it. Mission hospitals

were offered to the Government to be designated as District hospitals. The Church staff

gradually withdrew as more qualified Africans filled their positions.38 The 1960s were the

beginning of a new age. A time when rather than teaching, missionaries shared and exchanged

knowledge with the indigenous people, when indigenous people began to control the health care

system, and when the Government began to acknowledge its responsibility to provide

preventative health care to the citizens

Medical missions have continued to evolve since the beginning of the new age. Although

long-term medical missions are not common anymore, many Christians serve through non-

35
Schulpen, Integration of Church and Government, 118-119.
36
Schulpen, Integration of Church and Government, 116-119.
37
Schulpen, Integration of Church and Government, 66-73.
38
Schulpen, Integration of Church and Government, 119.
 Millar 15

governmental organizations, medical student missions, or short-term missions. Whatever form of

organization, those participating usually engage in providing specific care. Before the 1960s

most medical missionaries were required to perform all types of services. Dibble was expected to

graft skin one hour and then remove a spleen the next.39 Now, most medical missionaries

specialize in a specific area. In 2014, 90 percent of doctors had a specialty compared to only 29

percent in 1969.40 Preventative care has remained important and was adopted by the World

Health Organization as its official policy in 1978. However HIV/AIDS care has become a more

recent focus of non-governmental organizations (NGOs) and student medical teams. In the world

there are about 40 million carriers of HIV, and of that amount, 25 million are living in Africa.

The missionaries of the Catholic Church in Kenya provide 40 percent of the care to HIV

victims.41 Another new development is short-term missions. In the pioneering days of medical

missions, it was unrealistic for missionaries to travel back and forth from their home to a foreign

country. However, with the emergence of cheap airfare, short-term missions have become very

popular among medical students and youth groups.42 Finally, there has been a change in where

missionary doctors are stationed. In 1969, 70 percent of missionary doctors worked in a hospital

and 30 percent worked in a clinic. In 2014, missionary doctors worked with NGOs, in

government hospitals, and in prisons, with less than half working in mission hospitals.43 Medical

missions are anticipated to develop even more with the advancements of technology.44

39
Dibble, This Land of Eve, 60-63.
40
Greenall, “What is the future of medical mission?” 6-10.
41
Ololade Olakanmi and Philip A. Perry, “Medical Volunteerism in Africa: An Historical Sketch,” AMA Journal of
Ethics, December 2006, http://journalofethics.ama-assn.org/2006/12/mhst1-0612.html.
42
Tony Bartelme, “Medical Missions: Do No Harm?” Physician Leadership Journal 2, no. 2 (2015): 8-13.
43
Greenall, “What is the future of medical mission?” 6-10.
44
Greenall, “What is the future of medical mission?” 6-10.
 Millar 16

As with the rise of any new developments, new conflicts are inevitable. For instance,

since HIV/AIDS care has become a main focus, new disagreements have surfaced between

secular agencies and some conservative religious agencies. Because HIV/AIDS is obviously

related to sexual activity, certain religious agencies are unsure how to teach preventative care

without discrediting their belief that sex outside of marriage is a sin.45 Because secular

institutions and conservative religious agencies do not have the same perspective on sexual and

reproductive rights, certain religious institutions actively oppose abortions and disapprove of

condoms. However, some religious agencies have adapted their training on preventative

practices in consideration to the HIV/AIDS epidemic.46 Another issue has emerged from the

growing popularity of short-term missions. Although it is better to help a little than not at all, the

time, energy, and money needed for short-term missions could be more useful in other ways. For

instance, each person pays approximately 5,000 dollars-10,000 dollars for a few weeks abroad.

Instead, that money could be used to fund a local clinic for years.47 The time and energy spent on

short-term missions would be more effective if it was used to build sustainable systems. For

example, instead of providing simple procedures like tonsillectomies, short-term missions would

be more sustainable if they were used to teach and train indigenous people in new operations.

Whatever the issues, it is important to unify efforts in order to provide the best care possible.

Since the 1960s there have been changes to the delivery of medical care, but not any

significant changes in the relationships between the Church and Government or between the

missionaries and indigenous people. The Government is still responsible for most of the health

45
Ololade Olakanmi and Philip A. Perry, “Medical Volunteerism in Africa.”
46
Joanne E. Mantell et al, “Conflicts between conservative Christian institutions and secular groups in sub-Saharan
Africa: Ideological discourses on sexualities, reproduction, and HIV/AIDS,” Global Public Health, 6, no. 2 (2011):
192-209.
47
Tony Bartelme, “Medical Missions,” 8-13.
 Millar 17

services; however, the Government continues to be aided by mission groups or other voluntary

agencies. The missionaries have continually entrusted more responsibility to the indigenous

people. By examining the history of medical missions until independence and then the trends that

followed, the relationships appeared to transform for the better during the 1960s. Therefore, the

1960s should be characterized as the apex of medical missions.

 Millar 18

Bibliography

Bartelme, Tony. “Medical Missions: Do No Harm?” Physician Leadership Journal 2, no. 2

(2015): 8-13.

Dibble, J. Birney. The Plains Brood Alone: Tribesmen of the Serengeti. Grand Rapids, Michigan:

Zondervan Publishing House, 1973.

Dibble, J. Birney. This Land of Eve: A Year with an American Surgeon in East Africa. New

York: Abingdon Press, 1965.

Dibble, J. Birney. “Veterans’ Memoirs- Dr. Birney Dibble.” Interview by Lynnita Brown.

Korean War Educator, September 18, 1999. Accessed December 3, 2017.

http://www.koreanwar-educator.org/memoirs/dibble_birney/index.htm.

Etten, G.M. van. Rural Health Development in Tanzania. Van Gorcum & Company B.V., 1976.

Greenall, John. “What is the future of medical mission?” Nucleus, (2016): 6-10.

Mantell, Joanne E, Jacqueline Correale, Jessica Adams-Skinner, and Zena A. Stein. “Conflicts

between conservative Christian institutions and secular groups in sub-Saharan Africa:

Ideological discourses on sexualities, reproduction, and HIV/AIDS.” Global Public

Health 6, no. 2 (2011):192-209.

Olakanmi, Ololade, and Philip A. Perry. “Medical Volunteerism in Africa: An Historical

Sketch.” AMA Journal of Ethics. December 2006. http://journalofethics.ama-

assn.org/2006/12/mhst1-0612.html.
 Millar 19

Schulpen, T.W.J. Integration of Church and Government Medical Services in Tanzania. Effects

at District Level. Nairobi, Kenya: African Medical and Research Foundation, 1975.

Wall, Barbra Mann. Into Africa: A Transnational History of Catholic Medical Missions and

Social Change. New Brunswick: Rutgers University Press, 2015.