exchange will not help assure active peasant participation, particularly after fees
have been collected.
The concept of primary health care is nevertheless, revolutionary in the sense
that it comes close to the ideal situation discussed at the beginning of this chapter.
The primary health care approach in Zambia is approaching the situation diagrammatically shown in Figure 11.3. Limited resources are being provided to
support a more preventive programme to a larger part of the population with,
increasingly, a more labour-intensive (and less import-intensive) delivery system.
The departure from the previous paradigm has thus far been slow because of
certain inherent problems. However, stress on the use of community health
workers and other medical auxiliary staff, as well as on community participation
by public works construction techniques and other publicly supported programmes, are clear signs that a definite new pattern is being born in the country
(albeit with severe "birth pangs"). With it has come a new vocabulary and new
concepts such as catchment areas, accessibility, and community participation.
Indeed, it is now also recognized that people, not diseases, are to be treated.
Beck ( 1970, p. 200) has stated that in 1903 medical administrators were instructed,
first, to preserve the health of the European communities; second, to keep African and
Asian labour in good working condition; and third, to prevent the spread of epidemics.
As Doyal and
Pennel ( 1976, p. 162) have correctly noted, such a policy entailed selective
minimal health provisions for miners, plantation workers and railway builders--all crucial
in an extractive economy. The health problems of the masses (apart from the crucial
workers) were threatened by contagion.
Wilkinson ( 1968, p. 13) have reported that from the beginning of
their activity the mining companies in Zambia have provided health services for their
employees. They provide six hospitals and some urban clinics, with a total of 1,894 beds.
They add that these services cater for the settled population employed by the mining
companies. These hospitals (at Chililabombwe, Chibuluma, Luanshya, Mufulira, Chingola and Nkana [Kitwe]) are described as being "of a very high standard and are well-
staffed and obviously do excellent work" (p. 49).
Present coverage is expressed as a proportion, that is, the rural population within
a 12 kilometre radius as the crow flies (15 to 20 km in reality) to the total rural population.
Beck A. ( 1970) A History of British Medical Administration of East Africa 1900-1950. Cambridge, Mass.: Harvard University Press.
Benyoussef A. ( 1977) "Monitoring and Servicing National Health: Health Service Delivery in Developing Countries." International Social Science Journal, Vol. 29,
No. 3, pp. 397-418.
Doyal L., and
I. Pennell. ( 1976) "Pox Brittanica: Health, Medicine and Underdevelopment." Race and Class, Vol. 53, pp. 155-172.
Questia, a part of Gale, Cengage Learning. www.questia.com
Book title: Health Care Patterns and Planning in Developing Countries.
Contributors: Rais Akhtar - Editor.
Publisher: Greenwood Press.
Place of publication: New York.
Publication year: 1991.
Page number: 224.
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