No white magic
Sir: John Rowan Wilson (SPECTATOR, 14 June) poses the difficult question of using dispensers in African states postponing the establishment of university medical schools of the calibre of Kampala, Khartoum or Ibadan. It is just forty years since Sudan set up its 'native' midwifery schools. To await literacy and the standard of educa- tion now in existence in Sudan would have been stupid. I have seen the standard of skill achieved by non-writing village midwives trained by expert English mid- wives. In their final training they were taught to carry out delicate operations re- quired by the ancient custom of female circumcision and they undertook this sur- gical work as well as many other obstetr- ical manoeuvres with great skill. They are gradually being superseded and will pass into Sudanese history but for forty years they have achieved miracles many miles from towns or even roads. Dispensary centres in villages linked by radio to the 'radio doctor' copied from the Australian flying services has served well in Nigeria and we are proud that this work centres in Birmingham.
It is, however, important to exploit facilities as they exist. For example, in an advanced African country like Rhodesia with many miles of good roads and several splendid medical centres the challenge to develop a medical school of a calibre ab initio at least as powerful as an English medical school was accepted in 1958 when Birmingham University agreed to serve as mother to a daughter medical school in Salisbury. Despite the break up of the Federation and `UDI' this symbiosis has been a remarkable success. The new graduates are of high quality. The key man in this remarkable experiment is our Professor of Medicine W. M. Arnott. who took the view that the Feldscher, the village mid- wife and a first-rate university hospital and
medical school could coexist, provided of course Britain and Rhodesia could find the money.
Perhaps one of the hopeful results of this and other 'marriages' (such as Nig- eria and London) lies in the young members of the profession both in Africa and at home. Without realising it the students, midwives or doctors travelling between mother and daughter medical schools are modern ambassadors. To them the idea of one type of care for one type of colour and not for the other is absurd so that even in Salisbury there has never been any chal- lenge to the concept of a multi-racial teach- ing hospital. We feel sure that in the future this principle will be upheld.
The answer to John Rowan Wilson's question Feldscher midwife or medical school is. I believe—`all three' but this re- quires money, and of course, good will. Hugh Cameron McLaren Department of Obstetrics and Gynaecology, University of Birmingham
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