Traditions and Trust

Over centuries, what has become standardized medicine was developed along the line of these philosophies, and when formally instituted in Africa, orthodox medicine was laced with the bitter pill of colonization, and Western ideologies about medical ethics.

As modern medical practices improved globally, medical ethics have slowly evolved to suit a new world where patients are generally better informed, and more aware of their power and autonomy. But in Africa, medical ethics cannot improve without acknowledgment of the core failure of Western medical models applied on the continent, which excluded and even eradicated African methods, and ideals, of healthcare.

In Nigeria, society is divided along class and education. Around the world, these key indices affect both access to quality healthcare and how populations interact with health workers. Individuals with less education are often unable to properly advocate for their own health interests, a situation that is worsened by markers like gender and age. The legacy of colonization, and its philosophies, plays an important role in perpetuating the current situation.

By the end of the twentieth century, more medical training centres were being established in African countries, but only Nigeria and Côte d’Ivoire had more than ten medical schools in-country. Despite the paucity of schools, these pioneer institutions paved the way for professionalized health systems that were administered by Africans, to Africans. They also had significant drawbacks.

For example, before independence, the only medical school in Nigeria was University College Ibadan. Established in the 1940s, the training curriculum at University College Ibadan was designed to mirror the United Kingdom’s, to ensure that medical graduates from the institution were qualified to practice as physicians in Nigeria and in the UK. One impact of this was that it introduced standardized practice to patients. This was positive, as prior to the college’s establishment, Yaba Medical School was the only Nigerian institution that provided medical training, and it granted a lower-quality diploma to its graduates.