Historical Context and Traditional Versus Modern Health Care
Colonial policies in most Third World countries have been blamed for widespread disparities in the patterns of health care. The development of the Western health care system at the expense of the traditional system is considered to be the root cause of current health care problems. Nevertheless, the independence has not brought any equality in the distribution of services: The gap between haves and have-nots is widening over time and space. In some countries such as China traditional medicine has played a crucial role in the health services system. This part consists of six chapters--on Zambia, Ghana, Brazil, Nigeria, the Sudan, and the Gulf countries.
In Chapter 11 E. Shamilupa Kalapula discusses the historical context of health care delivery patterns during pre- and postindependence Zambia. He asserts that during the colonial period different health facilities existed for Africans and Europeans, and better health facilities were concentrated in urban and mining centres where Europeans lived. On the contrary, missionaries overwhelmingly provided health care in rural areas. Finally, curative rather than preventive medicine was fostered. Kalapula argues that, even after gaining independence, inequalities in health care provision continued to widen, and curative, rather than preventive, medicine continued to dominate. The adoption of the primary health care approach is the most important phase in the planning and delivery of health services. However, the departure from the previous paradigm has so far been slow because of certain inherent problems. Even so it is important that there now be a realization that one treats not diseases but people.
Charles Anyinam in Chapter 12 examines the continuance of colonial health policies in Ghana and their implications for the spatial organization